Seider Talia R, Luo Xi, Gongvatana Assawin, Devlin Kathryn N, de la Monte Suzanne M, Chasman Jesse D, Yan Peisi, Tashima Karen T, Navia Bradford, Cohen Ronald A
a Departments of Neurology, Psychiatry, and Aging , University of Florida , Gainesville , FL , USA.
J Clin Exp Neuropsychol. 2014;36(4):356-67. doi: 10.1080/13803395.2014.892061. Epub 2014 Mar 19.
In the current era of effective antiretroviral treatment, the number of older adults living with HIV is rapidly increasing. This study investigated the combined influence of age and HIV infection on longitudinal changes in verbal and visuospatial learning and memory.
In this longitudinal, case-control design, 54 HIV seropositive and 30 seronegative individuals aged 40-74 years received neurocognitive assessments at baseline visits and again one year later. Assessment included tests of verbal and visuospatial learning and memory. Linear regression was used to predict baseline performance and longitudinal change on each test using HIV serostatus, age, and their interaction as predictors. Multivariate analysis of variance (MANOVA) was used to assess the effects of these predictors on overall baseline performance and overall longitudinal change.
The interaction of HIV and age significantly predicted longitudinal change in verbal memory performance, as did HIV status, indicating that although the seropositive group declined more than the seronegative group overall, the rate of decline depended on age such that greater age was associated with a greater decline in this group. The regression models for visuospatial learning and memory were significant at baseline, but did not predict change over time. HIV status significantly predicted overall baseline performance and overall longitudinal change.
This is the first longitudinal study focused on the effects of age and HIV on memory. Findings suggest that age and HIV interact to produce larger declines in verbal memory over time. Further research is needed to gain a greater understanding of the effects of HIV on the aging brain.
在当前有效的抗逆转录病毒治疗时代,感染艾滋病毒的老年人数量正在迅速增加。本研究调查了年龄和艾滋病毒感染对语言及视觉空间学习与记忆纵向变化的综合影响。
在这项纵向病例对照设计中,54名40 - 74岁的艾滋病毒血清阳性个体和30名血清阴性个体在基线访视时接受了神经认知评估,并在一年后再次接受评估。评估包括语言和视觉空间学习与记忆测试。使用线性回归,以艾滋病毒血清状态、年龄及其相互作用作为预测因子,预测每项测试的基线表现和纵向变化。使用多变量方差分析(MANOVA)评估这些预测因子对总体基线表现和总体纵向变化的影响。
艾滋病毒与年龄的相互作用显著预测了语言记忆表现的纵向变化,艾滋病毒状态也是如此,这表明虽然血清阳性组总体下降幅度大于血清阴性组,但下降速度取决于年龄,即年龄越大,该组下降幅度越大。视觉空间学习与记忆的回归模型在基线时具有显著性,但未预测随时间的变化。艾滋病毒状态显著预测了总体基线表现和总体纵向变化。
这是第一项关注年龄和艾滋病毒对记忆影响的纵向研究。研究结果表明,年龄和艾滋病毒相互作用,导致语言记忆随时间出现更大幅度的下降。需要进一步研究以更深入了解艾滋病毒对衰老大脑的影响。