The veterans aging cohort study index is associated with concurrent risk for neurocognitive impairment.
Title | The veterans aging cohort study index is associated with concurrent risk for neurocognitive impairment. |
Publication Type | Journal Article |
Year of Publication | 2014 |
Authors | Marquine, MJ, Umlauf, A, Rooney, AS, Fazeli, PL, Gouaux, BD, Woods, SPaul, Letendre, SL, Ellis, RJ, Grant, I, Moore, DJ |
Corporate Authors | HIV Neurobehavioral Research Program (HNRP) Group |
Journal | J Acquir Immune Defic Syndr |
Volume | 65 |
Issue | 2 |
Pagination | 190-7 |
Date Published | 2014 Feb 01 |
ISSN | 1944-7884 |
Keywords | Adolescent, Adult, Aged, Aging, AIDS Dementia Complex, California, Cohort Studies, Female, Humans, Internal, Male, Middle Aged, Risk Assessment, Veterans, Young Adult |
Abstract | OBJECTIVE: The Veterans Aging Cohort Study (VACS) Index is predictive of mortality and combines age, traditional HIV biomarkers (HIV-1 plasma RNA and current CD4 count), and non-HIV biomarkers (indicators of renal and liver function, anemia, and hepatitis C coinfection). We examined the association between the VACS Index and HIV-associated neurocognitive impairment (NCI).DESIGN AND METHODS: Participants included 601 HIV-infected adults enrolled in cohort studies at the University of California, San Diego, HIV Neurobehavioral Research Program (ages: 18-76 years; 88% male; 63% white; median current CD4 = 364 cells/mm; 63% on antiretroviral therapy; AIDS = 64%). Biomarkers used in calculating the VACS Index were measured in prospectively collected blood samples using conventional laboratory methods. NCI was defined using global and seven domain deficit scores.RESULTS: Higher VACS Index scores were associated with concurrent risk for global NCI [P < 0.001; odds ratio = 1.21, confidence interval (CI): 1.12 to 1.32], even when adjusting for psychiatric comorbidities. This relation was statistically significant for most cognitive domains in adjusted models. Furthermore, the VACS Index predicted concurrent NCI beyond nadir CD4 and estimated duration of infection. Older age, lower hemoglobin, and lower CD4 counts were the VACS components most strongly linked to NCI.CONCLUSIONS: The findings extend previous research on the potential usefulness of the VACS Index in predicting HIV-associated outcomes to include NCI. Although the effect size was relatively small, our findings suggest that demographic information, HIV-disease factors, and common comorbidities might each play important roles in the clinical manifestation of cognitive impairment among HIV-infected individuals. Additional research is needed to determine if a more sensitive and specific index can be developed. |
DOI | 10.1097/QAI.0000000000000008 |
Alternate Journal | J Acquir Immune Defic Syndr |
PubMed ID | 24442225 |
PubMed Central ID | PMC3907119 |
Grant List | K24 MH097673 / MH / NIMH NIH HHS / United States T32 MH019934 / MH / NIMH NIH HHS / United States U24 MH100928 / MH / NIMH NIH HHS / United States R25 MH081482 / MH / NIMH NIH HHS / United States R25 MH080663 / MH / NIMH NIH HHS / United States R24 MH059745 / MH / NIMH NIH HHS / United States R24MH59745 / MH / NIMH NIH HHS / United States P30MH062512 / MH / NIMH NIH HHS / United States T32 DA031098 / DA / NIDA NIH HHS / United States P30 MH062512 / MH / NIMH NIH HHS / United States U01MH083506 / MH / NIMH NIH HHS / United States P01 DA012065 / DA / NIDA NIH HHS / United States U01 MH083506 / MH / NIMH NIH HHS / United States T32DA031098 / DA / NIDA NIH HHS / United States |