In:
JAIDS Journal of Acquired Immune Deficiency Syndromes, Ovid Technologies (Wolters Kluwer Health), Vol. 83, No. 3 ( 2020-03-1), p. 301-309
Abstract:
To determine whether domain-specific neurocognitive (NC) impairments predict falls in HIV+ compared with HIV− women. Design: Cross-sectional data analysis from 825 HIV+ and 392 HIV− women in the Women's Interagency HIV Study with NC testing within 2 years before falls surveys. Methods: NC impairment (T score 〈 40) was assessed in 7 domains: executive function, psychomotor speed, attention, learning, memory, fluency, and fine motor function. For domains associated with any fall within 6 months in simple logistic regression ( P 〈 0.05), hierarchical regression models evaluated associations between NC impairment and odds of falling, adjusting for: (1) study site and HIV, (2) demographics, (3) comorbid conditions, (4) substance use/central nervous system active medications, and HIV-specific factors. Results: Median age was higher in HIV+ than HIV− women (51 vs. 48 yrs); prevalence of falls was similar (19% HIV+, 16% HIV−). Overall, executive function [OR (odds ratio) = 1.82, 95% CI (confidence interval): 1.21 to 2.74; P = 0.004], psychomotor speed (OR = 1.59, 95% CI: 1.05 to 2.42, P = 0.03), and fine motor (OR 1.70, 95% CI: 1.11 to 2.61, P = 0.02) impairments were associated with greater odds of falls in fully adjusted models. In fully adjusted models, associations of executive function, psychomotor speed, and fine motor were nonsignificant among HIV+ women; conversely, among HIV− women, associations with impaired executive and fine motor functions were strengthened and remained significant. Conclusions: Cognitive impairment was associated with falls among middle-aged HIV− but not HIV+ women. Additional studies should elucidate mechanisms by which domain-specific NC impairment impacts fall risk among older HIV+ and HIV− women and how different factors modify relationships between cognition and falls.
Type of Medium:
Online Resource
ISSN:
1525-4135
DOI:
10.1097/QAI.0000000000002262
Language:
English
Publisher:
Ovid Technologies (Wolters Kluwer Health)
Publication Date:
2020
detail.hit.zdb_id:
2038673-4
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