Vascular risk factors, HIV serostatus, and cognitive dysfunction in gay and bisexual men. Neurology [Neurology] Journal article | | Title | Vascular risk factors, HIV serostatus, and cognitive dysfunction in gay and bisexual men. | | Author(s) | Becker JT, Kingsley L, Mullen J, Cohen B, Martin E, Miller EN, Ragin A, Sacktor N, Selnes OA, Visscher BR, Multicenter AIDS Cohort Study | | Institution | University of Pittsburgh School of Medicine, Pittsburgh, PA, USA. beckerjt@upmc.edu | | Source | Neurology 2009 Oct 20; 73(16):1292-9. | | MeSH | Aging
Bisexuality
Cardiovascular Diseases
Cerebrovascular Disorders
Cognition Disorders
Cohort Studies
Cross-Sectional Studies
HIV
HIV Infections
Homosexuality, Male
Humans
Male
Memory
Middle Aged
Neuropsychological Tests
Psychomotor Performance
RNA, Viral
Risk Factors
| | Abstract | BACKGROUND: The purpose of this study was to evaluate the relationship between cognitive performance, risk factors for cardiovascular and cerebrovascular disease (CVD), and HIV infection in the era of highly active antiretroviral therapy.
METHODS: We evaluated the cognitive functions of men enrolled in the cardiovascular disease substudy of the Multicenter AIDS Cohort Study who were aged > or =40 years, with no self-reported history of heart disease or cerebrovascular disease. Results from comprehensive neuropsychological evaluations were used to construct composite scores of psychomotor speed and memory performance. Subclinical CVD was assessed by measuring coronary artery calcium and carotid artery intima-media thickness (IMT), as well as laboratory measures, including total cholesterol, fasting glucose, glycosylated hemoglobin, glomerular filtration rate (estimated), and standardized blood pressure and heart rate measures.
RESULTS: After accounting for education, depression, and race, carotid IMT and glomerular filtration rate were significantly associated with psychomotor speed, whereas IMT was associated with memory test performance. HIV serostatus was not significantly associated with poorer cognitive test performance. However, among the HIV-infected individuals, the presence of detectable HIV RNA in plasma was linked to lower memory performance.
CONCLUSIONS: These findings suggest that HIV infection may not be the most important predictor of cognitive performance among older gay and bisexual men in the post-highly active antiretroviral therapy era, at least among those with access to medical care and to appropriate medications. Medical factors associated with normal aging are significantly associated with performance on neuropsychological tests, and good clinical management of these factors both in HIV-infected individuals and those at risk for infection may have beneficial effects in the short term and could reduce the risk of subsequent cognitive decline. | | Language | eng | | Pub Type(s) | Journal Article
Research Support, N.I.H., Extramural
| | PubMed ID | 19841381 |
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