Psychosocial risk factors and cognitive decline in people living with HIV: results from the Malaysian HIV and aging (MHIVA) study

ABSTRACT

HIV-associated mortality has improved with the advent of antiretroviral therapy, yet neurocognitive decline persists. We assessed the association between psychosocial risk factors and cognitive function among Malaysian PLWH. Data of virally suppressed PLWH (n = 331) on stable ART, from the Malaysian HIV and Aging study was assessed. Psychosocial factors were assessed using the Lubben Social Network Scale-6 (social isolation) and Depression Anxiety Stress Scale-21 (DASS-21). The Montreal Cognitive Assessment (MoCA) with normative standards for the Malaysian population was used to determine cognitive function. Linear and logistic regression were used to assess the associations between cognition, and psychosocial risk factors. Median age of participants was 43.8 years (IQR 37.7–51.0). Participants were predominantly male (82.8%), with secondary education or higher (85.2%). Participants were on ART for 5.7 years (IQR 3.0–9.7), with a mean MoCA score of 24.6 (±3.7). Social isolation was found in 34.6% of participants, and severe depression, severe stress, and severe anxiety in 10.6%, 15.4%, and 6.0% respectively. After adjusting for demographic, clinical, and HIV parameters, MoCA scores were significantly associated with severe stress (β = −0.11, p = 0.02) and having marginal friendship ties (β = −0.13, p = 0.03). Social isolation and severe stress are associated with neurocognitive impairment in PLWH.

KEYWORDS:

• HIV
• cognition
• psychosocial risk factors
• dementia
• aging

Acknowledgements

This work was supported by the High Impact Research Grants (HIR/MOHE; H-20001-E000001, UM.0000099/HIR.C3). M. Neelamegam was funded by the National Institutes of Health, Fogarty International Center (NIH, FIC) and the National Institute of Neurological Disorders and Stroke (NINDS) (award number D43TW010540).

Disclosure statement

No potential conflict of interest was reported by the author(s).

Declaration of conflict of interest

The authors report there are no competing interests to declare.

Additional information

Funding

This work was supported by Fogarty International Center: [Grant Number D43TW010540]; Ministry of Higher Education: [Grant Number HIR/MOHE; H-20001-E000001, UM.0000099/HIR.C3].