In:
Neurology, Ovid Technologies (Wolters Kluwer Health), Vol. 93, No. 3 ( 2019-07-16), p. e261-e271
Abstract:
Obesity is a common, modifiable cardiovascular and cerebrovascular risk factor. Among people with HIV, obesity may contribute to multisystem dysregulation including cognitive impairment. We examined body mass index (BMI) and central obesity (waist circumference [WC]) in association with domain-specific cognitive function and 10-year cognitive decline in men with HIV infection (MWH) vs HIV-uninfected (HIV−) men. Methods A total of 316 MWH and 656 HIV− Multicenter AIDS Cohort Study participants ≥40 years at baseline, with neuropsychological testing every 2 years and concurrent BMI and WC measurements, were included. MWH were included if taking ≥2 antiretroviral agents and had HIV-1 RNA 〈 400 copies/mL at 〉 80% of visits. Mixed-effects models included all visits from 1996 to 2015, stratified by HIV serostatus, and adjusted for sociodemographic, behavioral, and clinical characteristics. At baseline and follow-up, 8% of MWH and 15% of HIV− men and 41% of MWH and 56% of HIV− men were ≥60 years, respectively. Results Cross-sectionally, higher BMI was inversely associated with motor function in MWH and HIV− men, and attention/working memory in HIV− men. WC was inversely associated with motor function in MWH and HIV− men. Longitudinal associations indicated an obese BMI was associated with a less steep decline in motor function in MWH whereas in HIV− men, obesity was associated with a greater decline in motor function, learning, and memory. WC, or central obesity, showed similar patterns of associations. Conclusion Higher adiposity is associated with lower cognition cross-sectionally and greater cognitive decline, particularly in HIV− men. Overweight and obesity may be important predictors of neurologic outcomes and avenues for prevention and intervention.
Type of Medium:
Online Resource
ISSN:
0028-3878
,
1526-632X
DOI:
10.1212/WNL.0000000000007779
Language:
English
Publisher:
Ovid Technologies (Wolters Kluwer Health)
Publication Date:
2019
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