학술논문
Frailty and pre-frailty phenotypes increase the odds of abnormal cognitive impairment screens in people living with HIV
Document Type
Academic Journal
Author
Makinson, Alain; Allavena, Clotilde; Abulizi, Xian; Slama, Laurence; Case, Antoine; Trouillet, Marion Bourgey; Blondel, Guillaume Martin; Geny, Christian; Leclercq, Pascale; Cazanave, Charles; Bonnet, Fabrice; Naqvi, Alissa; David-Chevallier, Perla; Arvieux, Cédric; Katlama, Christine; Cabie, André; Andriantsoanirina, Valérie; Blain, Hubert; Meyer, Laurence
Source
AIDS. Aug 03, 2023
Subject
Language
English
ISSN
0269-9370
Abstract
OBJECTIVE:: Evaluate whether pre-frail and frail PLWH have a higher risk of cognitive impairment on screens. METHODS:: Analysis of PLWH aged 70 or older included in the ANRS EP66 SEPTAVIH cohort, on antiretroviral therapy for at least 12 months and with a MoCA test at enrolment. Adjusted risk of a Montreal Cognitive Assessment (MoCA) <26 was compared in frail/pre-frail versus robust PLWH. RESULTS:: A total of 503 PLWH were enrolled with a median age of 73 years, IQR [71–77], 81.5% were male, 73.8% were French natives, 32.9% had low socio-economic status (EPICES score >30.2), and 41.3% were college graduates; 27.3% had a history of clinical AIDS. 294 (58.5%) PLWH had a MoCA score <26; 182 (36%) a MoCA score ≤ 23. Frailty, pre-frailty, and robustness were found in 13.1%, 63.6% and 23.3% participants, respectively. PLWH with a MoCA < 26 had a significantly higher risk of being frail/prefrail, this before (OR = 2.31 [95% CI: 1.50, 3.57]), and after adjustment for confounders (OR = 1.80, [1.07–3.01]). The risk of being frail/prefrail in patients with a MoCA ≤ 23 was higher (adjusted OR = 2.75, [95%CI: 1.46–5.16]). Other factors independently associated with a MoCA < 26 were older age, birth outside of France, and a lower education level and being diabetic. CONCLUSIONS:: Abnormal MoCA screens were frequent in our cohort of PLWH aged 70 or older with controlled HIV disease. Cognitive impairment should be systematically screened in frail/prefrail PLWH. Frailty/pre-frailty, diabetes and social factors, but not HIV-related factors, are important determinants of cognitive function in PLWH with controlled disease.