Monroe A K, Zhang L, Jacobson L P, Plankey M W, Brown T T, Miller E N, Martin E, Becker J T, Levine A J, Ragin A, Sacktor N C
Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
HIV Med. 2017 Sep;18(8):555-563. doi: 10.1111/hiv.12490. Epub 2017 Mar 13.
HIV-associated neurocognitive disorders are highly prevalent, and physical activity (PA) is a modifiable behaviour that may affect neurocognitive function. Our objective was to determine the association between PA and neurocognitive function and the effect of HIV on this association.
PA was assessed in the Multicenter AIDS Cohort Study with the International Physical Activity Questionnaire. A neuropsychological test battery assessed global impairment and domain-specific impairment (executive function, speed of processing, working memory, learning, memory, and motor function) every 2 years. Semiannually, the Symbol Digit Modalities Test and Trail Making Test Parts A and B were performed. Adjusted logistic regression models were used to assess the PA-neurocognitive function association. Using longitudinal data, we also assessed the PA category-decline of neurocognitive function association with multivariate simple regression.
Of 601 men, 44% were HIV-infected. Low, moderate, and high PA was reported in 27%, 25%, and 48% of the HIV-infected men vs. 19%, 32% and 49% of the HIV-uninfected men, respectively. High PA was associated with lower odds of impairment of learning, memory, and motor function [odds ratio (OR) ranging from 0.52 to 0.57; P < 0.05 for all]. The high PA-global impairment association OR was 0.63 [95% confidence interval (CI) 0.39, 1.02]. Among HIV-infected men only, across multiple domains, the high PA-impairment association was even more pronounced (OR from 0.27 to 0.49). Baseline high/moderate PA was not associated with decline of any domain score over time. HIV infection was marginally associated with a higher speed of decline in motor function.
A protective effect of high PA on impairment in neurocognitive domains was observed cross-sectionally. Longitudinal PA measurements are needed to elucidate the PA-neurocognitive function relationship over time.
与HIV相关的神经认知障碍非常普遍，而身体活动（PA）是一种可改变的行为，可能会影响神经认知功能。我们的目的是确定PA与神经认知功能之间的关联以及HIV对这种关联的影响。
在多中心艾滋病队列研究中使用国际身体活动问卷对PA进行评估。每两年通过一套神经心理测试评估整体损害和特定领域损害（执行功能、处理速度、工作记忆、学习、记忆和运动功能）。每半年进行符号数字模态测试以及连线测验A和B部分。使用调整后的逻辑回归模型评估PA与神经认知功能的关联。利用纵向数据，我们还通过多元简单回归评估PA类别与神经认知功能下降之间的关联。
在601名男性中，44%感染了HIV。在感染HIV的男性中，分别有27%、25%和48%报告低、中和高强度的PA，而在未感染HIV的男性中这一比例分别为19%、32%和49%。高强度PA与学习、记忆和运动功能损害几率较低相关[优势比（OR）范围为0.52至0.57；所有P值均<0.05]。高强度PA与整体损害的关联OR为0.63[95%置信区间（CI）0.39，1.02]。仅在感染HIV的男性中，在多个领域，高强度PA与损害的关联更为明显（OR为0.27至0.49）。基线时的高/中度PA与任何领域得分随时间的下降均无关联。HIV感染与运动功能下降速度略快相关。
横断面研究观察到高强度PA对神经认知领域损害具有保护作用。需要进行纵向PA测量以阐明PA与神经认知功能随时间的关系。
