Cardiovascular risk factors and cognitive performance among people living with HIV: cross-sectional study in the country of Georgia.

OBJECTIVES

Older people living with HIV (PLWH) globally are experiencing a combination of both communicable and non-communicable disease (NCD) morbidities. Vascular contributions to cognitive impairment and dementia (VCID) can contribute to adverse ageing brain health. This study aimed to measure VCID and HIV-related factors and evaluate their association with cognitive performance.

DESIGN

A cross-sectional study.

SETTING

Five cities in the country of Georgia.

PARTICIPANTS

We enrolled PLWH age ≥40 years. Recruitment and data collection were carried out between February and September 2023. We conducted face-to-face interviews and collected data on sociodemographic characteristics, medical history, HIV history, cardiovascular health, mental health, clinical measurements and cognitive performance.

PRIMARY OUTCOME MEASURES

We calculated the estimated 10-year cardiovascular risk using the Framingham risk score (FRS). Descriptive analyses were conducted using the frequency distributions of relevant categorical variables and median and IQR for continuous variables. Multivariable linear regression analyses were conducted separately for each cognitive assessment score.

RESULTS

A total of 125 PLWH aged ≥40 years were enrolled in the study. The median FRS was 9% (IQR: 4, 15), with 37 (30%) participants having intermediate risk and 17 (14%) with high risk of cardiovascular event. In univariate correlation analysis, FRS was associated with worse cognitive performance. The FRS remained associated with worse performance on the Trails Making Test B and Grooved Pegboard Test using multivariable models. On average, every 1 per cent increase in FRS corresponded to an increase of 1.65 s (95% CI: 0.11, 3.19, p=0.04) for completing the Trails Making Test B and an increase of 1.02 s (95% CI: 0.43, 1.60, p=0.001) for completing the Grooved Pegboard Test.

CONCLUSIONS

We found a high prevalence of cardiovascular risk and an association between this risk and cognitive performance in our sample. Our findings provide a baseline that can be further investigated in larger-scale studies with longitudinal assessment of cardiovascular risk factors and cognitive performance. Furthermore, it can inform the development of policies and programmes to mitigate adverse effects of VCID on the health of PLWH in Georgia and the Eastern Europe and Central Asia region.