Pre-frailty predicts cognitive decline at 2-year follow-up in persons living with HIV

Abstract

Both HIV disease and frailty syndrome are risk factors for neurocognitive impairment. Longitudinal research among individuals of the general population suggests that frailty predicts future cognitive decline; however, there is limited evidence for these longitudinal relationships among people living with HIV (PLWH). The current study evaluated and compared rates of cognitive decline over 2 years among HIV serostatus and frailty status groups. Participants included 50 PLWH and 60 HIV-uninfected (HIV−) participants who were evaluated at baseline and 2-year follow-up visits. Baseline frailty status (non-frail, pre-frail, and frail) was determined using fried frailty phenotype criteria. Neurocognitive functioning was measured using practice-effect corrected scaled scores derived from a comprehensive neuropsychological battery covering seven cognitive domains. Repeated measures analysis was used to estimate rates of global and domain-specific cognitive change from baseline to 2-year follow-up among each of six HIV/frailty status groups. Among PLWH, the pre-frail group demonstrated consistent declines in global cognitive functioning (B = − 0.029, p = 0.034), processing speed (B = − 0.047, p = 0.031), and motor functioning (B = − 0.048, p = 0.038). Among HIV− participants, pre-frail individuals also declined in global cognitive functioning and processing speed (ps ≤ 0.05). HIV− non-frail participants also declined in the cognitive domains of learning, delayed recall, and motor functioning; however, these declines appeared to be driven by relatively higher baseline scores among this group. Notably, 38% of PLWH changed in frailty status from baseline to follow-up, and those with stable pre-frailty demonstrated higher likelihood for cognitive decline; change in depressive symptoms did not relate to change in frailty status. Current findings highlight pre-frailty as an important clinical syndrome that may be predictive of cognitive decline among PLWH. Interventions to prevent or reduce frailty among vulnerable PLWH are needed to maintain optimal cognitive health.

Brief Report: Frailty and HIV Disease Severity Synergistically Increase Risk of HIV-Associated Neurocognitive Disorders

“…We found that frailty is critical even at low levels. This is consistent with previous research showing that one to two symptoms of frailty (pre-frailty) is associated with neurocognitive impairments among community-dwelling adults 20 , and is predictive of neurocognitive decline over two years among PWH 21 . Furthermore, rates of frailty and pre-…”

Compassion toward others and self-compassion predict mental and physical well-being: a 5-year longitudinal study of 1090 community-dwelling adults across the lifespan

“…The influence of CTO and CTS on physical health was consistent with prior studies which showed that CTS improved lifestyle behaviors and metabolic biomarkers among adults with diabetes [ 47 , 55 , 91 ]. Reviews have found that CTS interventions can improve health behaviors from goal-setting and monitoring [ 92 ] to affective responses [ 93 ]. These psychosocial determinants of health are important factors to consider for improving health and well-being across the lifespan.…”

Neuropsychological Characteristics of Adults with HIV: A Systematic Review

“…Due to their descriptive nature and the impossibility of establishing causal relations, the studies included in this systematic review correspond to a 4b JBI (2014) evidence level, this level is low. Nonetheless, four of the studies can be considered of high methodological quality (>75%) [16][17][18][19] according to the JBI checklist and three with moderate quality (50-75%) [20][21][22][23][24][25][26] (Table 1). Regarding the evaluation of possible biases, we identified differences in age and formal education between the HIV+/HIV-groups in some comparative studies that could have influenced the results.…”

“…Most studies were conducted in Africa, including Sub-Saharan Africa [26], Zimbabwe [17], and a multicenter study from Kenya, Tanzania, and Uganda [22]; as well as Europe, including Italy [24], France [19], and a multicenter study from Switzerland [21]. The remaining studies originated in the USA [18], India [23], and Japan [16].…”