Departments of Epidemiology, Johns Hopkins University Center on Aging and Health, Johns Hopkins Bloomberg School of Public Health, 2024 E. Monument Street, Baltimore, MD, 21205, USA.
International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
J Neurovirol. 2017 Aug;23(4):558-567. doi: 10.1007/s13365-017-0527-y. Epub 2017 Apr 20.
Older HIV-infected men are at higher risk for both depression and cognitive impairments, compared to HIV-uninfected men. We evaluated the association between longitudinal patterns of depressive symptoms and attention/executive function in HIV-infected and HIV-uninfected men aged 50+ years to understand whether HIV infection influenced the long-term effect of depression on attention/executive function. Responses to the Center for Epidemiologic Studies-Depression scale and attention/executive function tests (Trail Making Test Part B and Symbol Digit Modalities Test) were collected semiannually from May 1986 to April 2015 in 1611 men. Group-based trajectory models, stratified by HIV status, were used to identify latent patterns of depressive symptoms and attention/executive function across 12 years of follow-up. We identified three depression patterns for HIV-infected and HIV-uninfected men (rare/never 50.0 vs. 60.6%, periodically depressed 29.6 vs. 24.5%, chronic high 20.5 vs.15.0%, respectively) and three patterns of attention/executive function for HIV-infected and HIV-uninfected men (worst-performing 47.4 vs. 45.1%; average 41.9 vs. 47.0%; best-performing 10.7 vs. 8.0%, respectively). Multivariable logistic regression models were used to assess associations between depression patterns and worst-performing attention/executive function. Among HIV-uninfected men, those in the periodically depressed and chronic high depressed groups had higher odds of membership in the worst-performing attention/executive function group (adjusted odds ratio [AOR] = 1.45, 95% CI 1.04, 2.03; AOR = 2.25, 95% CI 1.49, 3.39, respectively). Among HIV-infected men, patterns of depression symptoms were not associated with patterns of attention/executive function. Results suggest that HIV-uninfected, but not HIV-infected, men with chronic high depression are more likely to experience a long-term pattern of attention/executive dysfunction.
与未感染 HIV 的男性相比，感染 HIV 的老年男性患抑郁症和认知障碍的风险更高。我们评估了 HIV 感染和未感染的 50 岁以上男性纵向抑郁症状模式与注意力/执行功能之间的关联，以了解 HIV 感染是否会影响抑郁对注意力/执行功能的长期影响。1986 年 5 月至 2015 年 4 月期间，1611 名男性每半年接受一次抑郁症状的流行病学研究中心抑郁量表（Center for Epidemiologic Studies-Depression scale）和注意力/执行功能测试（Trail Making Test Part B 和 Symbol Digit Modalities Test）的回复。根据 HIV 状况，使用基于群组的轨迹模型，确定了在 12 年的随访期间，抑郁症状和注意力/执行功能的潜在模式。我们为 HIV 感染和未感染的男性确定了三种抑郁模式（罕见/从不抑郁 50.0%比 60.6%，周期性抑郁 29.6%比 24.5%，慢性高抑郁 20.5%比 15.0%）和三种注意力/执行功能模式（最差表现 47.4%比 45.1%，平均表现 41.9%比 47.0%，最佳表现 10.7%比 8.0%）。使用多变量逻辑回归模型评估抑郁模式与最差表现的注意力/执行功能之间的关联。在未感染 HIV 的男性中，周期性抑郁和慢性高抑郁组的成员更有可能属于注意力/执行功能最差的群体（调整后的优势比 [AOR] 分别为 1.45，95%置信区间 1.04-2.03；AOR 分别为 2.25，95%置信区间 1.49-3.39）。在 HIV 感染的男性中，抑郁症状模式与注意力/执行功能模式无关。结果表明，未感染 HIV 的男性中，慢性高抑郁的男性更容易出现长期的注意力/执行功能障碍模式。
