Associations between cognitive impairment and patient-reported measures of physical/mental functioning in older people living with HIV

Abstract Background Pain impacts up to 55% of people living with HIV (PLWH) and negatively impacts function. To date, limited data exist regarding factors that contribute to pain in older PLWH. Methods Data were utilized from the Aging with Dignity, Health, Optimism and Community (ADHOC) cohort, an observational study of older PLWH from ten clinics across the U.S. that collects patient-reported outcomes (PROs) on socioeconomic, psychosocial, and health factors. To measure pain, ADHOC participants were asked whether they had been diagnosed with back pain, hip pain, joint pain, or muscle pain, and were also instructed to report chronic pain conditions that were not listed. Bivariate analyses were performed to determine the associations between pain and PROs. Results Of 1,051 participants, 66% reported at least one type of pain. Factors associated with pain included multimorbidity, low income, anxiety, loneliness, depression, tobacco use, and older age (Table 1). Factors negatively associated with pain included employment, higher cognitive function, higher quality of life, greater resilience, higher social well-being, and alcohol use. Table 1. Characteristics associated with pain among older people living with HIV. Pairwise correlations are reported above using correlation coefficient r. Conclusion Improving pain management is currently a priority in the US healthcare system. Some factors identified in this study, including systemic issues such as socioeconomic status and employment, are not easily modifiable. Other factors, such as anxiety, depression, and smoking, are modifiable and therefore represent targets for interventions focused on improving pain and its sequelae in older PLWH. Disclosures Maile Karris, MD, Gilead Sciences (Grant/Research Support)Viiv Healthcare (Grant/Research Support) Peter Mazonson, MD, MBA, ViiV Healthcare (Grant/Research Support) Theoren Loo, MS, BS, ViiV Healthcare (Grant/Research Support) Jeff Berko, MPH, BS, ViiV Healthcare (Grant/Research Support) Frank Spinelli, MD, ViiV Healthcare (Employee) Andrew Zolopa, MD, ViiV Healthcare (Employee)

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Psychiatric symptom burden in older people living with HIV with and without cognitive impairment: the UCSF HIV over 60 cohort study

AIDS Care ◽

10.1080/09540121.2017.1281877 ◽

2017 ◽

Vol 29 (9) ◽

pp. 1178-1185 ◽

Cited By ~ 22

Author(s):

Benedetta Milanini ◽

Stephanie Catella ◽

Brandon Perkovich ◽

Pardis Esmaeili-Firidouni ◽

Lauren Wendelken ◽

...

Keyword(s):

Cohort Study ◽

Cognitive Impairment ◽

Older People ◽

Psychiatric Symptom ◽

Symptom Burden ◽

People Living With Hiv ◽

Living With Hiv

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Substance Use Among Older People Living With HIV: Challenges for Health Care Providers

Frontiers in Public Health ◽

10.3389/fpubh.2019.00094 ◽

2019 ◽

Vol 7 ◽

Cited By ~ 9

Author(s):

Sherry Deren ◽

Tara Cortes ◽

Victoria Vaughan Dickson ◽

Vincent Guilamo-Ramos ◽

Benjamin H. Han ◽

...

Keyword(s):

Health Care ◽

Substance Use ◽

Older People ◽

Health Care Providers ◽

People Living With Hiv ◽

Care Providers ◽

Living With Hiv

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Quality of life in people living with HIV-associated neurocognitive disorder: A scoping review study

PLoS ONE ◽

10.1371/journal.pone.0251944 ◽

2021 ◽

Vol 16 (5) ◽

pp. e0251944

Author(s):

Kate Alford ◽

Stephanie Daley ◽

Sube Banerjee ◽

Jaime H. Vera

Keyword(s):

Quality Of Life ◽

Cognitive Impairment ◽

Scoping Review ◽

Chronic Conditions ◽

Healthy Aging ◽

Cognitive Disorder ◽

World Health ◽

People Living With Hiv ◽

Living With Hiv

Quality of life (QoL) is recognized as an essential end point in the disease management of chronic conditions such as HIV with calls to include good QoL as a ‘fourth 90’ in the 90-90-90 testing and treatment targets introduced by World Health Organization in 2016. Cognitive impairments impact a broad spectrum of experiences and are a common issue effecting people living with HIV (PLWH). Despite this, few studies have examined QoL in PLWH who also have a cognitive disorder. This study aimed to synthesize and describe what is known about QoL in those living with HIV-associated neurocognitive disorders (HAND). A scoping review of peer-reviewed literature was conducted to identify how QoL has been investigated and measured in PLWH with HAND, and how PLWH with HAND report and describe their QoL. We searched PsychInfo, Medline, Scopus, and Web of Science along with hand-searching reference lists from relevant studies found. Included studies were those published in English after 1st January 2003 which included PLWH with cognitive impairment not due to other pre-existing conditions. Fifteen articles met criteria for inclusion. Two studies measured QoL as a primary aim, with others including QoL assessment as part of a broader battery of outcomes. The MOS-HIV and SF-36 were the most commonly used measures of overall QoL, with findings generally suggestive of poorer overall QoL in PLWH with HAND, compared to PLWH without cognitive impairment. Studies which examined dimensions of QoL focused exclusively on functionality, level of independence, and psychological QoL domains. There is a considerable dearth of research examining QoL in PLWH with HAND. The initiatives which advocate for healthy aging and improved QoL in PLWH must be extended to include and understand the experiences those also living with cognitive impairment. Research is needed to understand the broad experiential impacts of living with these two complex, chronic conditions, to ensure interventions are meaningful to patients and potential benefits are not missed.

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‘When you take pills you must eat’: Food (in)security and ART adherence among older people living with HIV

Global Public Health ◽

10.1080/17441692.2019.1644361 ◽

2019 ◽

Vol 15 (1) ◽

pp. 97-110

Author(s):

Lucia Knight ◽

Enid Schatz ◽

Kaleea R. Lewis ◽

Ferdinand C. Mukumbang

Keyword(s):

Older People ◽

People Living With Hiv ◽

Art Adherence ◽

Living With Hiv

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Cognitive Impairment Among Aging People Living With HIV on Antiretroviral Therapy

Journal of the Association of Nurses in AIDS Care ◽

10.1097/jnc.0000000000000122 ◽

2020 ◽

Vol 31 (3) ◽

pp. 301-311 ◽

Cited By ~ 1

Author(s):

Xueling Xiao ◽

Hui Zeng ◽

Caiyun Feng ◽

Hang Tan ◽

Lanlan Wu ◽

...

Keyword(s):

Cognitive Impairment ◽

Antiretroviral Therapy ◽

People Living With Hiv ◽

Living With Hiv ◽

Aging People

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Self-reported Health and Personal Social Networks of Older People Living with HIV/AIDS in Lomé, Togo

Journal of Cross-Cultural Gerontology ◽

10.1007/s10823-014-9238-5 ◽

2014 ◽

Vol 29 (3) ◽

pp. 329-338 ◽

Cited By ~ 3

Author(s):

Ami R. Moore ◽

Victor Prybutok

Keyword(s):

Social Networks ◽

Older People ◽

People Living With Hiv ◽

Reported Health ◽

Personal Social Networks ◽

Living With Hiv ◽

Hiv Aids

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352. Characteristics Associated with Pre-Frailty in Older People Living with HIV

Open Forum Infectious Diseases ◽

10.1093/ofid/ofz360.425 ◽

2019 ◽

Vol 6 (Supplement_2) ◽

pp. S186-S186

Author(s):

Peter Mazonson ◽

Theoren Loo ◽

Jeff Berko ◽

Sarah-Marie Chan ◽

Ryan Westergaard ◽

...

Keyword(s):

Logistic Regression ◽

Regression Analysis ◽

Cognitive Function ◽

Older People ◽

Logistic Regression Analysis ◽

The United States ◽

People Living With Hiv ◽

Factors Associated ◽

Increased Risk ◽

Living With Hiv

Abstract Background Frailty is a concern among older people living with HIV (PLHIV). There is a paucity of research characterizing PLHIV who are at risk of becoming frail (pre-frailty). To investigate how HIV impacts older PLHIV in the United States, a new study called Aging with Dignity, Health, Optimism and Community (ADHOC) was launched at ten sites to collect self-reported data. This analysis uses data from ADHOC to identify factors associated with pre-frailty. Methods Pre-frailty was assessed using the Frailty Index for Elders (FIFE), where a score of zero indicated no frailty, 1–3 indicated pre-frailty, and 4–10 indicated frailty. A cross-sectional analysis was performed on 262 PLHIV (age 50+) to determine the association between pre-frailty and self-reported sociodemographic, health, and clinical indicators using bivariate analyses. Factors associated with pre-frailty were then included in a logistic regression analysis using backward selection. Results The average age of ADHOC participants was 59 years. Eighty-two percent were male, 66% were gay or lesbian, and 56% were white. Forty-seven percent were classified with pre-frailty, 26% with frailty, and 27% with no frailty. In bivariate analyses, pre-frailty was associated with depression, low cognitive function, depression, multiple comorbidities, low income, low social support and unemployment (Table 1). In the multiple logistic regression analysis, pre-frailty was associated with having low cognitive function (Odds Ratio [OR] 8.56, 95% Confidence Interval [CI]: 3.24–22.63), 4 or more comorbid conditions (OR 4.00, 95% CI: 2.23–7.06), and an income less than $50,000 (OR 2.70, 95% CI: 1.56–4.68) (Table 2). Conclusion This study shows that commonly collected clinical and sociodemographic metrics can help identify PLWH who are more likely to have pre-frailty. Early recognition of factors associated with pre-frailty among PLHIV may help to prevent progression to frailty. Understanding markers of increased risk for pre-frailty may help clinicians and health systems better target multi-modal interventions to prevent negative health outcomes associated with frailty. Disclosures All authors: No reported disclosures.

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