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PWH Have Higher depression Rates Than People without HIV: Some Depressive Symptoms Wane With Age in HIV Group-Some Do Not
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.....relatively young group, see table. Maybe they wane because people get used to living with them, not that they go away. Jules
International Workshop on HIV & Aging 2023, October 26-27, Washington, DC
Reported by Mark Mascolini for NATAP and Academic Medical Education
UCSD investigators concluded that people with HIV have "disproportionately higher rates of depression" than people without HIV, confirming earlier findings.
Affective and cognitive depressive symptoms and apathy waned with age in people with HIV infection in an analysis of 3848 men and women with and without HIV [1]. But somatic symptoms and anhedonia persisted into older age. The study also confirmed that people with HIV carry a heavier burden of depressive symptoms than people without HIV, but this trend diminished with age.
University of California, San Diego (UCSD) researchers reminded colleagues that depression remains twice as prevalent in people with HIV infection as in the general population. Research links older age to declining depression rates in the general population, the researchers noted, but studies of depression and aging with HIV have yielded inconsistent results.
The UCSD study involved HIV-positive and -negative people from all HIV Neurobehavioral Research Center data collection points in the United States. All completed the Beck Depression Inventory-II (BDI-II) questionnaire about depressive symptoms [2]. BDI-II incorporates 5 subscales: somatic, anhedonia, apathy, affective, and cognitive. Linear regression analyses to explore BDI-II subscale outcomes had HIV status, age, and their interaction as predictors; covariates were sex, race, neurocognitive impairment (global deficit score), and lifetime substance use disorder.
The study group had 3057 people with HIV and 791 people without HIV. The HIV group contributed a significantly higher proportion of men than the non-HIV group (81.2% vs 18.8%, P < 0.001), lower proportions of whites (46.3% vs 56.4%) and Hispanics (16.8% vs 22.3%) and a higher proportion of blacks (34.1% vs 16.1%) (P < 0.001). The non-HIV group had more education years (13.3 vs 12.9, P <
0.001), a lower proportio
n of lifetime substance users (65.9% vs 71.4%, P < 0.001), and a lower proportion with neurocognitive impairment (28.8% vs 43.0%, P < 0.001).
People with HIV reported significantly more depressive symptoms across the five BDI-II subscales (affective, beta = 0.19; cognitive, beta = 0.16; somatic, beta = 0.30; anhedonia, beta = 0.24, apathy, beta = 0.19) (P < 0.05 for all). For the combined HIV-positive and -negative group, older age led to fewer affective (beta = -0.08), cognitive (beta = -0.15) and apathy (beta = -0.03) symptoms (P < 0.05 for all), but older age did not significantly diminish somatic and anhedonia symptoms. Unadjusted models found a statistically significant HIV x age interaction indicating that the difference between people with and without HIV in somatic symptoms narrowed as people aged.
For the whole group, in adjusted models factors significantly associated with greater depressive symptoms across the five subscales were lifetime history of substance use, being female, being white versus black, and greater neurocognitive impairment.
UCSD investigators concluded that people with HIV have "disproportionately higher rates of depression" than people without HIV, confirming earlier findings. This greater toll of depressive symptoms with HIV declined with age, but only for affective, cognitive, and apathy symptoms-not for somatic and anhedonia symptoms. Because of this disparity, the researchers suggested that interventions for older people with HIV and depression should focus on somatic and anhedonia symptoms.
References
1. Ham L, Prescott M, Ellis R, et al. Disparities in depressive symptoms among people with HIV diminish with older age. International Workshop on HIV & Aging 2023, October 26-27, Washington, DC. Abstract 15.
2. Naviaux lab. UCSD. BDI-II.
https://naviauxlab.ucsd.edu/wp-content/uploads/2020/09/BDI21.pdf
link to oral session
https://www.youtube.com/watch?v=Spy2t42krWA
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