The aggregate effects of multiple comorbid risk factors on cognition among HIV-infected individuals

Sapna M. Patel Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA; VA Greater Los Angeles Healthcare System, Los Angeles, CA, USACorrespondence[email protected]

April D. Thames Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA; VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA

Natalie Arbid VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA

Stella E. Panos Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA; VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA

Steven Castellon Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA; VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA

Charles H. Hinkin Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA; VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA

Abstract

This study developed and then cross-validated a novel weighting algorithm based on multiple comorbid risk factors (stimulant use, vascular disease, hepatitis C, HIV disease severity, cognitive reserve) to predict cognitive functioning among 366 HIV+ adults. The resultant “risk severity score” was used to differentially weight, as a function of age, the impact and magnitude of multiple risk factors on cognition. Among older adults (≥50 years) the risk severity index was differentially predictive of learning/memory and verbal fluency, whereas among younger adults it was linked to working memory and executive function. Cognitive reserve was found to be the most robust predictor of neurocognition.

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Acknowledgments

This study was supported by a grant from the National Institute on Drug Abuse (R01 DA 13799) and by the National Institute of Mental Health Training Grant (T32 MH19535; PI: Charles Hinkin). Dr. Patel and Dr. Panos are supported by the NIMH Institutional Training Grant (No. T32MH19535) and Dr. Thames is supported by NIMH Grant (No. K23MH095661). We would also like to acknowledge the help from members of our laboratory: Sara-Beth Lawrence, Tim Arentsen, and Vanessa Streiff.

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The aggregate effects of multiple comorbid risk factors on cognition among HIV-infected individuals

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