Associations between cognitive impairment and patient‐reported measures of physical/mental functioning in older people living with HIV1. Issue 5 (26th October 2016)

• Record Type: Journal Article
• Authors: Underwood, J; De Francesco, D; Post, FA; Vera, JH; Williams, I; Boffito, M; Mallon, PW; Anderson, J; Sachikonye, M; Sabin, C; Winston, A
• Other Names: Asboe David investigator.; Garvey Lucy investigator.; Pozniak Anton investigator.; Campbell Lucy investigator.; Yurdakul Selin investigator.; Okumu Sara investigator.; Pollard Louise investigator.; Otiko Damilola investigator.; Phillips Laura investigator.; Laverick Rosanna investigator.; Fisher Martin investigator.; Clarke Amanda investigator.; Bexley Andrew investigator.; Richardson Celia investigator.; Macken Alan investigator.; Ghavani‐Kia Bijan investigator.; Maher Joanne investigator.; Byrne Maria investigator.; Flaherty Ailbhe investigator.; Mguni Sifiso investigator.; Clark Rebecca investigator.; Nevin‐Dolan Rhiannon investigator.; Pelluri Sambasivarao investigator.; Johnson Margaret investigator.; Ngwu Nnenna investigator.; Hemat Nargis investigator.; Jones Martin investigator.; Carroll Anne investigator.; Whitehouse Andrew investigator.; Burgess Laura investigator.; Babalis Daphne investigator.; Stott Matthew investigator.; McDonald Linda investigator.; Higgs Chris investigator.; Seah Elisha investigator.; Fletcher Stephen investigator.; Anthonipillai Michelle investigator.; Moyes Ashley investigator.; Deats Katie investigator.; Syed Irtiza investigator.; Matthews Clive investigator.;
• Is Part Of: HIV medicine. Volume 18:Issue 5(2017:May)
• Page Start: 363
• Page End: 369
• Publication Date: 2016-10-26
• Subjects: activities of daily living -- cognitive impairment -- HIV -- patient‐reported outcomes; HIV infections -- Treatment -- Periodicals; HIV-positive persons -- Periodicals; HIV infections -- Treatment -- Decision making -- Periodicals; 616.9792
• DOI: 10.1111/hiv.12434
• Languages: English
• ISSNs: 1464-2662

Abstract

Abstract : Objectives: While cognitive impairment is frequently reported in HIV‐positive individuals and has historically been associated with poorer functional outcomes, the associations between cognitive impairment and patient‐reported outcome measures (PROMs) in contemporary cohorts are unclear. Methods: We tested cognitive function using a computerized battery (CogState ™ ) in 290 HIV‐positive and 97 HIV‐negative individuals aged ≥ 50 years participating in the Pharmacokinetic and Clinical Observations in People Over Fifty (POPPY) study. Participants completed questionnaires detailing physical and mental health [Short Form Health Survey (SF‐36)], cognitive function [European AIDS Clinical Society (EACS) questions], activities of daily living [Lawton Instrumental Activities of Daily Living (IADL)], depression [Patient Depression Questionnaire (PHQ‐9) and Centres for Epidemiologic Studies Depression scale (CES‐D)], falls and sexual desire. Cognitive impairment was defined using the Frascati criteria, global deficit score (GDS) and multivariate normative comparison (MNC). In the HIV‐positive group, the classification performances of the different definitions of cognitive impairment and dichotomized questionnaire results were calculated. Results: The prevalence of cognitive impairment in the HIV‐positive group was 34.5% (GDS), 30.0% (Frascati) and 22.1% (MNC), with only 2% diagnosed with HIV‐associated dementia. In general, the associations between cognitive impairment and PROMs were weak regardless of the definition used: mean c‐statistics were 0.543 (GDS), 0.530 (MNC) and 0.519 (Frascati). Associations were similar using the global T‐score to define cognitive impairment. Summary health scores (SF‐36) were lower, but only significantly so for those with cognitive impairment identified using MNC, for both mental health (61.4 vs . 75.8; P = 0.03) and physical health (60.9 vs . 75.0; P = 0.03). Conclusions: The associations between cognitive impairment and PROMs were weak, possibly because impairment was mild and therefore largely asymptomatic. Further work is needed to elucidate the clinical implications of cognitive impairment in HIV‐disease.