 |
|
|
| |
MIDLIFE ADIPOSITY PREDICTS COGNITIVE DECLINE IN
THE MULTICENTER AIDS COHORT STUDY (MACS)
|
| |
| |
"⇑: total and central adiposity associated with ⇓: baseline cognition in HIV+ & HIV-men. Specifically, ⇑: adiposity associated with ⇓: motor function in both groups & attention/working memory in HIV-men"
Reported by Jules Levin
CROI 2019 March 4-7 Seattle
Leah H. Rubin1,2,3, Deborah Gustafson4, Kellie L. Hawkins5,6, Long Zhang2, Lisa P. Jacobson2, James T. Becker7, Cynthia A. Munro1,3, Jordan E. Lake8, Eileen Martin9, Andrew Levine10, Todd T. Brown11, Ned C. Sacktor1, & Kristine M. Erlandson5
1Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD; 2Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; 3 Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD; 4Department of Neurology, State University of New York Downstate Medical Center, Brooklyn, NY; 5 University of Colorado, Aurora, Colorado; 6Denver Public Health, Denver, Colorado; 7Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA; 8Departments of Medicine, University of Texas Health Science Center at Houston, Houston, TX; 9Department of Psychiatry, Rush University Medical Center, Chicago, IL; 8Department of Neurology, David Geffen School of Medicine at the University of California, Los Angeles, CA; 9Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD
Program abstract
Among adults with HIV infection, obesity may contribute to multisystem dysregulation including cognitive impairments. We examined body mass index (BMI) and central obesity (waist circumference, WC) in association with domain-specific cognitive function and 10-year cognitive decline in adult men living with HIV infection (HIV+) compared to at-risk men without HIV infection (HIV-).
The longitudinal Multicenter AIDS Cohort Study (MACS) of HIV infection among HIV+ men and at-risk controls (HIV-) provide data for these analyses. Inclusion criteria included: >40 years old at first neuropsychological testing; and for HIV+ men, ≥2 antiretroviral agents and HIV-1 RNA 80% of visits. Outcomes included neuropsychological test scores measured every 2 years. Tests included: learning (RAVLT total learning, Rey immediate recall), memory (RAVLT delayed recall, Rey delayed recall), executive function (TMT-Part B, Stroop interference trial), processing speed (SDMT, Stroop color-naming trial), sustained attention and working memory (CALCAP mean simple and complex reaction time), and fine motor function (GPEG-dominant and non-dominant hand). Exposures included baseline BMI and WC. Linear mixed effects models included all available visits from 1996-2015, adjusted for baseline sociodemographic, behavioral, and clinical characteristics, stratified by HIV-serostatus.
Among 972 (316 HIV+ and 656 HIV-) men at baseline, higher BMI (≥25 kg/m2) was cross-sectionally associated with lower motor function in HIV+ and HIV-, and lower attention/working memory in HIV- men. Obese WC (≥102 cm, 40 inches) was associated with lower motor function in HIV+ and HIV- men. Longitudinal analyses (Fig 1) indicated that overweight (BMI 25.0-29.9 kg/m2) or obese (BMI ≥30 kg/m2) vs normal BMI (18.5 to 24.9 kg/m2) was associated with less decline in motor function in HIV+ men, but greater decline in motor function, memory, and learning in HIV- men. WC showed similar patterns.
Higher BMI and central obesity are associated with lower cognitive performance cross-sectionally and greater cognitive decline, particularly in HIV- men. Overweight and obesity may be important predictors of mid-life neuropsychological outcomes and later-life cognitive impairments, and should be considered in prevention and intervention planning.
|
| |
|
|
|
|
|
