Association Between Cognitive Tests and Antiretroviral Medication Adherence in Older Adults With HIV
Association Between Cognitive Tests and Antiretroviral Medication Adherence in Older Adults With HIV
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DOI：
10.1177/1060028018798327
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发表时间：
2019-02-01
影响因子：
2.9
通讯作者：
Schweizer, Mark S.
中科院分区：
文献类型：
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作者：
Caballero, Joshua;Ownby, Raymond L.;Schweizer, Mark S.
背景：艾滋病毒携带者中增长最快的人群之一是老年人，特别是65岁或以上的老年人。目前的抗逆转录病毒疗法(ART)延长了艾滋病毒感染者的预期寿命。然而，为了使治疗有效，患者需要坚持治疗。随着时间的推移，携带艾滋病毒的老年人可能会经历艾滋病毒相关的神经认知障碍或其他可能影响抗逆转录病毒治疗坚持的因素。使用便利的认知测试来帮助衡量服药依从性，可能对这些患者的最佳护理有用。目的：探讨认知测验与ART依从性的关系。方法：这是一项前瞻性研究，评估65岁或65岁以上的HIV感染者。使用的认知测试包括执行时钟绘制任务(CLOX)1和2，轨迹制作测试A和B部分，以及凹槽钉板测试(GPB)。用1个月以上的用药事件监测系统作为依从性的主要衡量标准。结果：CLOX-1和GPB与粘附性显著相关(P<；0.05)。比较每个指标与依从性的关系的大小表明，GPB是一个更好的粘附性指标(R=0.514比R=0.381)。结论和相关性：在65岁或65岁以上的HIV感染者中，CLOX 1和GPB表明与依从性有关。尽管使用这些测试来衡量老年艾滋病毒携带者的依从性似乎很有希望，但还需要更多的研究来确定它们的最终效用。
Background: One of the fastest growing populations living with HIV is older adults especially those 65 years of age or older. Current antiretroviral therapy (ART) has prolonged life expectancy of persons with HIV. However, for therapy to be effective, patients need to be adherent. Over time, older persons with HIV may experience HIV-associated neurocognitive disorders or other factors that could affect ART adherence. The use of expedient cognitive tests that help measure medication adherence may be useful for the optimal care of these patients. Objective: To investigate the association between cognitive tests and ART adherence. Methods: This was a prospective study evaluating patients 65 years of age or older with HIV. Cognitive tests used included the Executive Clock-Drawing Task (CLOX) 1 and 2, Trail Making Test parts A and B, and Grooved Pegboard Test (GPB). The medication event monitoring system cap over 1 month was used as the primary measure for adherence. Results: CLOX 1 and GPB were significantly related to adherence (P < 0.05). Comparison of the magnitude of each measure's relation to adherence suggests that the GPB is a better indicator of ability to adhere (R = 0.514 vs R = 0.381). Conclusion and Relevance: CLOX 1 and GPB demonstrated an association with adherence in patients 65 years of age or older with HIV. Although the use of these tests to measure adherence in older persons with HIV seems promising, more research is needed to ascertain their ultimate utility.