Baliashvili Davit, Imerlishvili Esma, Karaulashvili Ana, DeHovitz Jack, Gustafson Deborah R, Djibuti Mamuka
Partnership for Research and Action for Health, Tbilisi, Georgia
Partnership for Research and Action for Health, Tbilisi, Georgia.
BMJ Open. 2025 Mar 24;15(3):e090918. doi: 10.1136/bmjopen-2024-090918.
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.
A cross-sectional study.
Five cities in the country of Georgia.
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.
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.
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.
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.
全球老年艾滋病毒感染者（PLWH）同时面临传染病和非传染病（NCD）合并症。血管性认知障碍和痴呆（VCID）会对老年大脑健康产生不利影响。本研究旨在测量VCID及与艾滋病毒相关的因素，并评估它们与认知表现的关联。
横断面研究。
格鲁吉亚国家的五个城市。
我们纳入了年龄≥40岁的PLWH。2023年2月至9月进行招募和数据收集。我们进行了面对面访谈，并收集了社会人口学特征、病史、艾滋病毒病史、心血管健康、心理健康、临床测量和认知表现等方面的数据。
我们使用弗雷明汉风险评分（FRS）计算估计的10年心血管风险。使用相关分类变量的频率分布以及连续变量的中位数和四分位距进行描述性分析。对每个认知评估分数分别进行多变量线性回归分析。
本研究共纳入125名年龄≥40岁的PLWH。FRS中位数为9%（四分位距：4，15），37名（30%）参与者有中度风险，17名（14%）有心血管事件高风险。在单变量相关性分析中，FRS与较差的认知表现相关。使用多变量模型时，FRS在连线测验B和沟槽插板测验中仍与较差表现相关。平均而言，FRS每增加1%，完成连线测验B的时间增加1.65秒（95%置信区间：0.11，3.19，p = 0.04），完成沟槽插板测验的时间增加1.02秒（95%置信区间：0.43，1.60，p = 0.001）。
我们发现样本中心血管风险患病率较高，且该风险与认知表现之间存在关联。我们的研究结果提供了一个基线，可在对心血管危险因素和认知表现进行纵向评估的大规模研究中进一步探究。此外，它可为制定政策和计划提供参考，以减轻VCID对格鲁吉亚以及东欧和中亚地区PLWH健康的不利影响。
