 |
|
|
| |
Cognitive trajectories among people with HIV attending a dedicated memory clinic for PLWH
|
| |
| |
EACS 2023 Oct 18-21
Samuel Rhodes1, Kate Alford1, Clara O'Brien3, Eileen Nixon2, Colin Fitzpatrick2, Sube Banerjee4, Jaime H Vera1,2
1Centre for Global Health Research, Brighton and Sussex Med School, UK ,2HIV department, University Hospitals Sussex NHS , UK, 3Department of Neuropsychology, University Hospitals Sussex NHS , 4Faculty of Medicine and Health Sciences, University of Nottingham, UK
purpose
Cognitive impairment (CI) in people living with HIV (PLWH) is multifactorial and requires an holistic approach to management. In this study we evaluated changes in cognitive performance of PLWH with symptomatic CI over time following patient centred clinical interventions initiated by a dedicated memory clinic for PLWH with CI in Brighton, UK.
method
Standardised neuropsychological tests obtained at baseline and follow up from patients attending a HIV memory clinic between 2016 and 2022 were compared. Cognitive impairment was defined by global and per-cognitive domain Z scores. To evaluate clinically significant changes in cognitive performance over time global deficit scores and reliable change index scores at both baseline and reassessment were compared against normative scores using one-sample t-tests. Number and type of management interventions provided by the clinic were quantified.
results
38 out of 136 patients attending the clinic during the study period had a clinically indicated reassessment to track progression of CI and the impact of interventions. Most re-assessed patients were male 84% (32) and white 79% (30) with a median age (range) of 56 (36-75) years. 93%(33) had an undetectable viral load and the mean time (SD) between re-assessments was 16 (10) months. 196 interventions were provided to patients. Interventions included comorbidity management and lifestyle recommendations in 31% (33), mental health support 19% (22), HIV therapy management 11% (16) and cognitive remediation 6% (11). A trend of improvement in global cognitive performance (RBANS total index scores from 77.2 to 78.5) and most domains was observed, particularly in RBANS delayed memory index t(33)=-2.431, p<0.03,><0.03. (figure 1).>
conclusions
In this real-life cohort of PLWH with CI, cognitive performance remained stable or improved in the majority of PLWH following patient centred interventions managing factors traditionally associated with CI in PLWH.
|
| |
|
|
|
|
|
