Cognitive Performance and Frailty in Older HIV-Positive Adults.
Cognitive Performance and Frailty in Older HIV-Positive Adults.
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老年艾滋病毒阳性者的认知表现和虚弱。
DOI：
10.1097/qai.0000000000001790
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发表时间：
2018
期刊：
影响因子：
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通讯作者：
Ances,BeauM
中科院分区：
文献类型：
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作者：
Paul,RobertH;Cooley,SarahA;Garcia-Egan,PaolaM;Ances,BeauM
目的：本研究探讨了认知状态的相对贡献，以脆弱的老年人感染HIV+。设计：参与者包括122个HIV+的个人[平均年龄= 57.5（6.6）]与中位CD 4细胞计数为546。在94%的样本中观察到不可检测的病毒载量（< 50拷贝/mL）。根据Fried表型标准，将样本定义为虚弱（n= 21）和非虚弱（n= 101）。认知测试包括执行功能、运动/心理、语言、学习和记忆的测量。性能被转换为标准化的分数和平均计算个人领域的分数和全球指数的cognitive function.Methods：Logistic和分层回归分别完成，以确定临床，人口统计学和认知变量之间的关联，至于frailty status.Results：结果的Logistic回归显示，较低的执行功能，女性性别，和较高的抑郁症状与脆弱。分层分析显示，在考虑女性性别和抑郁症状后，执行功能对脆弱状态的贡献不显著（Nagelkerke R2 = 0.15）。结论：这些结果强调了性别分布和心理健康在HIV脆弱解释模型中的重要性。此外，针对抑郁症症状的干预措施可能会增加老年艾滋病毒感染者的复原力。
Objective:This study examined the relative contribution of cognitive status to frailty among older individuals infected with HIV+.Design:Participants included 122 HIV+ individuals [mean age= 57.5 (6.6)] with a median CD4 cell count of 546. Undetectable viral load (< 50 copies per mL) was observed in 94% of the sample. The sample was defined as frail (n= 21) and nonfrail (n= 101) according to the Fried phenotype criteria. Cognitive tests included measures of executive function, motor/psychomotor, language, learning, and memory. Performances were converted to standardized scores and averaged to calculate individual domain scores and a global index of cognitive function.Methods:Logistic and hierarchical regressions were completed to separately determine the associations between clinical, demographic, and cognitive variables with regards to frailty status.Results:Results of the logistic regressions revealed that lower executive function, female sex, and higher symptoms of depression were associated with frailty. The hierarchical analysis revealed no significant contribution of executive function to frailty status after accounting for female sex and symptoms of depression (Nagelkerke R 2= 0.15).Conclusions:These results emphasize the importance of sex distribution and mental health in explanatory models of frailty in HIV. Further, interventions targeting symptoms of depression may increase resilience in older HIV+ individuals.