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Publication Detail
Self-Reported Decline in Everyday Function, Cognitive Symptoms, and Cognitive Function in People With HIV.
  • Publication Type:
    Journal article
  • Publication Sub Type:
  • Authors:
    Laverick R, Haddow L, Daskalopoulou M, Lampe F, Gilson R, Speakman A, Antinori A, Bruun T, Vassilenko A, Collins S, Rodger A, Cognitive Impairment in People with HIV in the European Region (CIPHER) Study Group
  • Publisher:
    Lippincott Williams & Wilkins Ltd.
  • Publication date:
  • Pagination:
    e74, e83
  • Journal:
    Journal of acquired immune deficiency syndromes
  • Volume:
  • Issue:
  • Medium:
  • Status:
  • Print ISSN:
  • Language:
  • Keywords:
    Cognitive Impairment in People with HIV in the European Region (CIPHER) Study Group, Humans, HIV Infections, Activities of Daily Living, Risk Factors, Regression Analysis, Cognition, Cognition Disorders, Neuropsychological Tests, Adult, Middle Aged, Female, Male
  • Addresses:
    *Research Department of Infection and Population Health, University College London, London, United Kingdom; †National Institute for Infectious Diseases, Lazzaro Spallanzani, Rome, Italy; ‡Department of Infectious Diseases, University of Copenhagen, Copenhagen, Denmark; §Belarusian State Medical University, Minsk, Belarus; and ∥HIV i-Base, London, United Kingdom.
We determined factors associated with self-reported decline in activities of daily living (ADLs) and symptoms of cognitive impairment in HIV positive adults in 5 European clinics.HIV+ adults underwent computerized and pen-and-paper neuropsychological tests and questionnaires of cognitive symptoms and ADLs. We considered cognitive function in 5 domains, psychosocial factors, and clinical parameters as potentially associated with symptoms. Separate regression analyses were used to determine factors associated with a decline in ADL (defined as self-reported decline affecting ≥2 ADLs and attributed to cognitive difficulties) and self-reported frequency of symptoms of cognitive impairment. We also estimated the diagnostic accuracy of both questionnaires as tests for cognitive impairment.Four hundred forty-eight patients completed the assessments [mean age 45.8 years, 84% male, 87% white, median CD4 count 550 cells/mm, median time since HIV diagnosis 9.9 years, 81% virologically suppressed (HIV-1 plasma RNA <50 copies/mL)]. Ninety-six (21.4%) reported decline in ADLs and attributed this to cognitive difficulties. Self-reported decline in ADLs and increased symptoms of cognitive impairment were both associated with worse performance on some cognitive tests. There were also strong associations with financial difficulties, depressive and anxiety symptoms, unemployment, and longer time since HIV diagnosis. Both questionnaires performed poorly as diagnostic tests for cognitive impairment.Patients' own assessments of everyday function and symptoms were associated with objectively measured cognitive function. However, there were strong associations with other psychosocial issues including mood and anxiety disorders and socioeconomic hardship. This should be considered when assessing HIV-associated cognitive impairment in clinical care or research studies.
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