Effect of Aging and Human Immunodeficiency Virus Infection on Cognitive Abilities

Authors


Address correspondence to Dr. Nicoletta Ciccarelli, Institute of Clinical Infectious Diseases, Catholic University of the Sacred Heart, Largo Agostino Gemelli 8, Rome 00168, Italy. E-mail: nicoletta.ciccarelli@rm.unicatt.it

Abstract

Objectives

To explore the combined effects of aging and human immunodeficiency virus (HIV) infection on cognitive decay.

Design

Cross-sectional, single-cohort study.

Setting

Institute of Clinical Infectious Diseases, Catholic University of the Sacred Heart, Rome, Italy.

Participants

One hundred fifty-three asymptomatic HIV-positive (HIV+) outpatients (20% aged ≥ 60) and an age- and education-matched control population of 39 HIV-negative individuals.

Measurements

A neuropsychological investigation was conducted to compare four groups of participants classified on the basis of HIV serostatus and age (<60 vs ≥60). The effects of age and HIV infection on neuropsychological performance were analyzed using a two-by-two factorial analysis of variance. Demographic and clinical variables associated with neuropsychological performance were identified using linear regression analysis in the HIV+ population.

Results

HIV infection and aging had significant negative effects on cognitive performance, but no significant interaction was observed between these two factors. Although older HIV+ participants had worse cognitive performance, they showed no distinct cognitive pattern from younger HIV+ participants. Moreover, younger HIV+ participants' performance on memory tasks was qualitatively and quantitatively comparable with that of older HIV− participants, despite the dramatic age difference.

Conclusion

Aging and HIV might be additive factors in the expression of cognitive decline. As the HIV+ population ages, routine neuropsychological examinations could help clinicians better understand and manage the expression of cognitive impairment.

Ancillary