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Cardiovascular Risk Linked to Poor Memory Independently of Age in HIV+
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4th International Workshop on HIV and Aging, October 30-31, 2013, Baltimore
Mark Mascolini
A composite cardiovascular risk score accounted for significant variance in verbal and nonverbal memory performance independently of age, according to results of a study involving 62 HIV-positive US veterans [1]. After statistical adjustment for cardiovascular risk, age itself did not account for significant variance in memory function.
The US Veterans Administration (VA) cares for more than 24,000 HIV-positive veterans, and two thirds of veterans with HIV are between 50 and 69 years old. Thus US veterans provide a large population in which to study aging issues in people with HIV. Prior research demonstrated negative associations between older age or greater cardiovascular risk and cognitive function, including memory, in HIV-positive people. To assess potential associations between age, cardiovascular risk, and memory, VA researchers conducted this analysis of HIV-positive veterans in the Baltimore area.
Participants completed the brief visuospatial memory test-revised (BVMT-R, a verbal memory measure) and the Hopkins verbal learning test-revised (HVLT-R). The researchers extracted cardiovascular risk factors from medical records and created a composite cardiovascular risk score for each veteran.
The analysis included 62 veterans, 61 of them (98%) men and 48 (77%) African American. Study group age averaged 54.4 years (+/-9.4) and years of education 12.2 (+/-2.3).
Cardiovascular risk was associated with decreased memory when measured as immediate recall (-0.44, P < 0.01), delayed recall (-0.41, P < 0.01), average verbal memory (-0.34, P < 0.05), and average nonverbal memory (-0.37, P < 0.01). Older age was also associated with worse immediate recall (-0.30, P < 0.05), delayed recall (-0.31, P < 0.01), average verbal memory (-0.12, not significant), and average nonverbal memory (-0.42, P < 0.01). Cardiovascular risk and age correlated positively with each other (r = 0.31, P < 0.05).
Heirarchical multiple regression determined that, after statistical adjustment for age, the number of cardiovascular risk factors accounted for significant variance in nonverbal memory (r(2)delta = 0.83, P < 0.05) and verbal memory (r(2)delta = 0.11, P < 0.05). But in the same kind of analysis, after adjustment for cardiovascular risk factors, older age did not account for significant variance in nonverbal or verbal memory.
A separate study of HIV-positive Baltimore veterans determined that, after statistical adjustment for infectious disease burden, noninfectious disease burden accounted for almost 40% of variance in overall neurocognitive function, including executive function (11%), processing speed (18%), working memory (28%), and learning and memory (30%) [2]. But after controlling for noninfectious disease burden, infectious disease burden did not account for significant variance in neurocognitive function.
To pursue their analysis of aging, cardiovascular risk, and neurocognitive performance in veterans with HIV, the VA team created the Successful Aging for Veterans with Immunodeficiency (SAVI) Clinic, in which veterans will undergo neurocognitive testing, physical exam, assessment of overall health and infectious disease status, and physical performance testing. These investigators also plan to measure the impact of an exercise intervention on health of veterans with HIV.
Reference
1. Kakos L, Lee-Wilk T, Oursler KA, Dux M. The role of cardiovascular risk and aging in memory performance in a sample of veterans with HIV. 4th International Workshop on HIV and Aging, October 30-31, 2013, Baltimore. Abstract 14.
2. Steinberg TC, Dux M, Lee-Wilk T. Neurocognitive function in veterans living with HIV/AIDS. 4th International Workshop on HIV and Aging, October 30-31, 2013, Baltimore. Abstract 26.
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