Abstract
The HIV-infected older adult (HOA) community is particularly vulnerable to cognitive impairment. Previous studies in the general older adult population have reported that lower scores on tests of cognitive function often correlate negatively with aerobic fitness [5-7]. HIV-infected individuals have significantly reduced aerobic fitness and physical function compared to HIV-uninfected individuals. Determining important correlates of cognitive ability may be beneficial in not only detecting precursors to future cognitive impairments, but also target areas for interventions. The purpose of this study was to investigate the relationship between cognitive ability and aerobic fitness in HIV-infected older adults. We conducted a cross-sectional study of HOA on antiretroviral therapy (ART) >50 years of age. Domain specific cognitive function was assessed by means of a neuropsychological battery. Aerobic fitness (VO2peak) was assessed using a graded, progressive treadmill test. Thirty-seven HOA on ART (mean±SD: age 59±6 years, BMI 28±5, CD4 663±337 cells/ml, duration since HIV diagnosis 17±7 years; 81% males) completed the cognitive tests. Several domains of cognition were significantly associated with VO2peak by Spearman correlation analysis (p<0.05). By step-wise adjusted regression VO2peak was most frequently and significantly related to many cognitive domains such as verbal and visual memory, visual perception, and language (p<0.05). We found that participants with higher Vo2peak were less likely to have more severe forms of HIV-associated neurocognitive disorders (HAND) such as mild neurocognitive disorder (OR=0.65; p=0.01) and HIV-associated dementia (OR=0.64; p=0.0006). In HOA and in conclusion, aerobic fitness is related to cognitive performance on various tasks. The likelihood of cognitive impairment increased with lower fitness levels. Therefore, increased fitness may serve an important factor in maintenance of cognition and neural integrity for aging HIV-infected individuals. Future prospective and large scale studies are needed to evaluate the effect of fitness and vascular stiffness and function on cognition and brain structure among HOA.
Highlights
The number of older adults with the human immunodeficiency virus (HIV) has markedly increased in the last 20 years; an increase which is largely attributed to the success of antiretroviral therapy (ART) [1,2]
On classifying HIV-associated neurocognitive disorders (HAND) diagnosis we found that 9 subjects had normal cognitive function, 5 subjects had Asymptomatic Neurocognitive Impairment (ANI), 7 subjects had Mild Neurocognitive Disorder (MNC) and 12 subjects had HAD
The results of this study demonstrated that aerobic fitness is predictive of cognitive ability on various tasks in HIV-infected older adult (HOA) on ART
Summary
The number of older adults with the human immunodeficiency virus (HIV) has markedly increased in the last 20 years; an increase which is largely attributed to the success of antiretroviral therapy (ART) [1,2]. Previous studies in older adults have demonstrated the interrelationship between aerobic fitness and cognitive ability [5,6,7] These studies report that lower scores on tests of cognitive function often correlate negatively with aerobic fitness. While informative, these previous studies primarily focus on the general older adult population. These previous studies primarily focus on the general older adult population It remains uncertain whether the association between cognitive and physical fitness measures can be observed in the HOA community.
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