Increased Prevalence of Neurocognitive Impairment in Aging People Living With Human Immunodeficiency Virus: The ANRS EP58 HAND 55–70 Study

Makinson, Alain; Dubois, Jonathan; Eymard-Duvernay, Sabrina; Leclercq, Pascale; Zaegel-Faucher, Olivia; Bernard, Louis; Vassallo, Mattéo; Barbuat, Claudine; Gény, Christian; Thouvenot, Éric; Costagliola, Dominique; Ozguler, Anna; Zins, Marie; Simony, Mélanie; Reynes, Jacques; Berr, Claudine

doi:10.1093/cid/ciz670

Cited by 22 publications

(21 citation statements)

References 40 publications

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“…The availability of combination antiretroviral therapy (cART) has greatly improved life expectancy among persons with HIV (PWH) who have access to adequate health care (Samji et al, 2013). Despite the beneficial effects of cART on controlling HIV viremia, neurocognitive impairment remains prevalent among PWH, particularly in PWH aged 50 and older (Cherner et al, 2004;Makinson et al, 2019). However, recent studies demonstrate that some PWH are able to achieve successful cognitive aging (i.e., generally defined as preserved cogntion and everyday functioning; Malaspina et al, 2011;Moore et al, 2014Moore et al, , 2018.…”

Section: Introductionmentioning

confidence: 99%

Objective and subjective sleep measures are associated with neurocognition in aging adults with and without HIV

Campbell

Kohli

Lee

et al. 2020

The Clinical Neuropsychologist

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Objective: Poor sleep quality is related to worse neurocognition in older adults and in people with HIV (PWH); however, many previous studies have relied only on self-report sleep questionnaires, which are inconsistently correlated with objective sleep measures. We examined relationships between objective and subjective sleep quality and neurocognition in persons with and without HIV, aged 50 and older. Method: Eighty-five adults (PWH n ¼ 52, HIV-negative n ¼ 32) completed comprehensive neuropsychological testing to assess global and domain-specific neurocognition. Objective sleep quality was assessed with wrist actigraphy (total sleep time, efficiency, sleep fragmentation) for five to 14 nights. Subjective sleep quality was assessed with the Pittsburgh Sleep Quality Index. Results: Objective and subjective sleep measures were unrelated (p's > 0.30). Compared to HIV-negative participants, PWH had greater sleep efficiency (80% vs. 75%, p ¼ 0.05) and were more likely to be using prescription and/or over the counter sleep medication (p ¼ 0.04). In the whole sample, better sleep efficiency (p < 0.01) and greater total sleep time (p ¼ 0.05) were associated with better learning. Less sleep fragmentation was associated with better learning (p < 0.01) and recall (p ¼ 0.04). While PWH had slightly stronger relationships between total sleep time and sleep fragmentation, it is not clear if these differences are clinically meaningful. Better subjective sleep quality was associated with better executive function (p < 0.01) and working memory (p ¼ 0.05); this relationship was primarily driven by the HIV-negative group. Conclusions: Objective sleep quality was associated with learning and recall whereas subjective sleep quality was associated with executive function and working memory. Therefore, assessing objective and subjective sleep quality could be clinically useful, as they are both related to important domains of cognition frequently impacted in HIV-associated neurocognitive ARTICLE HISTORY

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Section: Introductionmentioning

confidence: 99%

Objective and subjective sleep measures are associated with neurocognition in aging adults with and without HIV

Campbell

Kohli

Lee

et al. 2020

The Clinical Neuropsychologist

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“…This study serves as an example of how understanding the dynamic relationships between daily life activities and cognition could lead to improved symptoms or disease tracking or just-in-time adaptive interventions to promote optimal neurocognitive functioning, when desired, using digital health technologies. Such interventions may be important for older adults [ 25 ] and persons with HIV [ 26 , 27 ], particularly older persons with HIV, given the higher rates of neurocognitive impairment compared with the general population.…”

Section: Introductionmentioning

confidence: 99%

Daily Activities Related to Mobile Cognitive Performance in Middle-Aged and Older Adults: An Ecological Momentary Cognitive Assessment Study

Campbell¹,

Paolillo²,

Heaton³

et al. 2020

JMIR Mhealth Uhealth

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Background Daily activities have been associated with neurocognitive performance. However, much of this research has used in-person neuropsychological testing that requires participants to travel to a laboratory or clinic, which may not always be feasible and does not allow for the examination of real-time relationships between cognition and behavior. Thus, there is a need to understand the real-time relationship between activities in the real world and neurocognitive functioning to improve tracking of symptoms or disease states and aid in the early identification of neurocognitive deficits among at-risk individuals. Objective We used a smartphone-based ecological momentary cognitive assessment (EMCA) platform to examine real-time relationships between daily activities and neurocognitive performance (executive functioning and verbal learning) in the everyday environment of middle-aged and older adults with and without HIV. Methods A total of 103 adults aged 50-74 years (67 persons with HIV; mean age 59 years, SD 6.4) were recruited from the University of California, San Diego HIV Neurobehavioral Research Program and the San Diego community. Participants completed our EMCA protocol for 14 days. Participants reported their current daily activities 4 times per day; following 2 of the 4 daily ecological momentary assessment (EMA) surveys, participants were administered the mobile Color-Word Interference Test (mCWIT) and mobile Verbal Learning Test (mVLT), each once per day. Activities were categorized into cognitively stimulating activities, passive leisure activities, and instrumental activities of daily living (IADLs). We used multilevel modeling to examine the same-survey and lagged within-person and between-person effects of each activity type on mobile cognitive performance. Results On average, participants completed 91% of the EMA surveys, 85% of the mCWIT trials, and 80% of the mVLT trials, and they reported engaging in cognitively stimulating activities on 17% of surveys, passive leisure activities on 33% of surveys, and IADLs on 20% of surveys. Adherence and activity percentages did not differ by HIV status. Within-persons, engagement in cognitively stimulating activities was associated with better mCWIT performance (β=−1.12; P=.007), whereas engagement in passive leisure activities was associated with worse mCWIT performance (β=.94; P=.005). There were no lagged associations. At the aggregate between-person level, a greater percentage of time spent in cognitively stimulating activities was associated with better mean mVLT performance (β=.07; P=.02), whereas a greater percentage of time spent in passive leisure activities was associated with worse mean mVLT performance (β=−.07; P=.01). IADLs were not associated with mCWIT or mVLT performance. Conclusions Smartphones present unique opportunities for assessing neurocognitive performance and behavior in middle-aged and older adults’ own environment. Measurement of cognition and daily functioning outside of clinical settings may generate novel insights on the dynamic association of daily behaviors and neurocognitive performance and may add new dimensions to understanding the complexity of human behavior.

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“…Approximately 15-50% of people living with HIV (PLWH) show HIV-associated neurocognitive disorder (HAND) (Schouten et al, 2011). The prevalence varies according to the population studied and increases with age (Makinson et al, 2019). Methods used to define impairment also have an impact on the prevalence (Underwood et al, 2019).…”

Section: Introductionmentioning

confidence: 99%

Altered Gray Matter Volume and Functional Connectivity in Human Immunodeficiency Virus-Infected Adults

et al. 2020

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People living with human immunodeficiency virus (HIV) (PLWH) are at high risk of neurocognitive impairment. The pathogenesis of neurocognitive impairment remains unclear, and there is still no diagnostic biomarker. By coupling three-dimensional T1-weighted imaging and resting-state functional imaging, we explored structural and functional alterations in PLWH and examined whether such imaging alterations had the potential to denote neurocognitive function. A total of 98 PLWH and 47 seronegative controls aged 20–53 years were recruited. Structural alterations were first explored between HIV-negative controls and PLWH. Subsequently, brain regions showing gray matter alterations were used as seeds for separate whole-brain functional connectivity (FC) analysis. Finally, the relationships between imaging alterations and cognitive function were explored. PLWH suffered from thalamus, occipital lobe, and hippocampus/parahippocampus atrophy. Visual cortices in PLWH showed decreased anticorrelation with the posterior cingulate cortex and left angular gyrus of the default mode network. FC within the visual cortices (between the left calcarine and right calcarine) and in the thalamic prefrontal circuit and between the thalamus and somatosensory association cortex were also altered. In addition, FC between the left thalamus and right dorsolateral prefrontal cortex in the cognitively impaired group was significantly different from that in the cognitively normal group in PLWH. Partial correlation analysis uncorrected for multiple comparisons suggested that some imaging alterations can be associated with neurocognition. Our study supports the presence of brain atrophy and functional reconfiguration in PLWH. Imaging alterations can be associated with neurocognitive function. We hold that neuroimaging is a promising approach in evaluating PLWH and might have the potential to clarify the pathogenesis of HIV-associated neurocognitive disorder.

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Increased Prevalence of Neurocognitive Impairment in Aging People Living With Human Immunodeficiency Virus: The ANRS EP58 HAND 55–70 Study

Cited by 22 publications

References 40 publications

Objective and subjective sleep measures are associated with neurocognition in aging adults with and without HIV

Objective and subjective sleep measures are associated with neurocognition in aging adults with and without HIV

Daily Activities Related to Mobile Cognitive Performance in Middle-Aged and Older Adults: An Ecological Momentary Cognitive Assessment Study

Altered Gray Matter Volume and Functional Connectivity in Human Immunodeficiency Virus-Infected Adults

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