Department of Psychology, University of Houston, 3695 Cullen Blvd, 126 Heyne Bldg (Ste. 239d), Houston, TX, 77204, USA.
Department of Psychology and c Gerontology Institute, Georgia State University, P.O. Box 5010, Atlanta, GA, 30302, USA.
J Neurovirol. 2024 Apr;30(2):1-11. doi: 10.1007/s13365-024-01201-2. Epub 2024 Mar 28.
Although older adults with HIV are at high risk for mild neurocognitive disorders, a subset experience successful cognitive aging (SCA). HIV is associated with an increased risk of vascular depression (VasDep), which can affect cognitive and daily functioning. The current study examined whether VasDep impedes SCA among older adults with HIV. 136 persons with HIV aged 50 years and older were classified as either SCA+ (n = 37) or SCA- (n = 99) based on a battery of demographically adjusted neurocognitive tests and self-reported cognitive symptoms. Participants were also stratified on the presence of vascular disease (e.g., hypertension) and current depression as determined by the Composite International Diagnostic Interview and the Depression/Dejection scale of the Profile of Mood States. A Cochran-Armitage test revealed a significant additive effect of vascular disease and depression on SCA in this sample of older adults with HIV (z = 4.13, p <.0001). Individuals with VasDep had the lowest frequency of SCA+ (0%), which differed significantly from the group with only vascular disease (30%, OR = 0.04, CI = 0.002,0.68)) and the group with neither vascular disease nor depression (47% OR = 0.02, CI = 0.33,0.001). Findings were not confounded by demographics, HIV disease severity, or other psychiatric and medical factors (ps > 0.05). These data suggest that presence of VasDep may be a barrier to SCA in older adults with HIV disease. Prospective, longitudinal studies with neuroimaging-based operationalizations of VasDep are needed to further clarify this risk factor's role in the maintenance of cognitive and brain health in persons with HIV disease.
尽管感染 HIV 的老年人有发生轻度认知障碍的高风险,但有一部分人会出现成功的认知老化(SCA)。HIV 会增加血管性抑郁(VasDep)的风险,这可能会影响认知和日常功能。目前的研究检查了 VasDep 是否会阻碍感染 HIV 的老年人出现 SCA。根据一系列经过人口统计学调整的神经认知测试和自我报告的认知症状,将 136 名年龄在 50 岁及以上的 HIV 感染者分为 SCA+(n=37)或 SCA-(n=99)。根据复合国际诊断访谈和心境状态问卷的抑郁/沮丧量表,参与者还按血管疾病(如高血压)的存在和当前抑郁进行分层。Cochran-Armitage 检验显示,血管疾病和抑郁对 HIV 老年患者的 SCA 存在显著的相加效应(z=4.13,p<.0001)。患有 VasDep 的个体出现 SCA+的频率最低(0%),与仅有血管疾病的组(30%,OR=0.04,CI=0.002,0.68)和既无血管疾病也无抑郁的组(47%,OR=0.02,CI=0.33,0.001)有显著差异。研究结果不受人口统计学、HIV 疾病严重程度或其他精神和医学因素的影响(p>.05)。这些数据表明,VasDep 的存在可能是 HIV 老年患者 SCA 的障碍。需要进行前瞻性、纵向研究,以神经影像学为基础来对 VasDep 进行操作性定义,从而进一步阐明该风险因素在维持 HIV 患者认知和大脑健康方面的作用。