In Older Adults With HIV, Higher CVD Risk May Lead to Poorer Cognitive Function

A higher cardiovascular (CV) risk score may help identify individuals with HIV who are at risk for future cognitive impairment, according to new findings that were presented yesterday at the Conference on Retroviruses and Opportunistic Infections (CROI) 2019.

Study co-author Dr Felicia C. Chow, from the University of California San Francisco, spoke about the findings.

To assess whether the Atherosclerotic Cardiovascular Disease (ASCVD) and Framingham Heart Study Global CVD (FRS) risk scores could accurately predict cognitive function in older individuals with HIV, the researchers analyzed data on participants aged 40 years or older with HIV, all of whom were from the multicenter AIDS Clinical Trials Group HAILO Study.

In all, 988 participants from the HAILO study were identified as being eligible for this new study because they had had neurocognitive testing both at entry and at year 4.

At baseline, the participants had an ASCVD risk score of 6.8% and an FRS of 13.1%, with men having significantly higher risk scores in both measurements.

By analyzing the association between the participants’ baseline 10-year CV risk score and their NPZ-4 at year 4, the researchers determined that baseline CV risk did predict the participants’ future cognitive function.

For every 1% higher baseline ASCVD risk, NPZ-4 at year 4 was lower by 1.4 standard deviation, with this negative impact on cognitive function being greater among women than men (-3.6 vs -1.6).

While the FRS had a similar trend, the effect was smaller, with the association being statistically significant only among men.

After adjusting for covariates, the association between CV risk score and cognitive function remained statistically significant in women but not men. Among women, ASCVD significantly predicted NPZ-4 at year 4, but the effects were smaller with FRS.

“There are a number of questions raised by our study’s findings that lay out the path for future directions, including whether higher cardiovascular risks can predict cognitive decline and incident cognitive impairment and what are the mechanisms that are underlying CVD and its connection with cognitive impairment,” concluded Chow.

—Colleen Murphy

Reference:

Chow FC. Cardiovascular risk scores predict longitudinal cognitive function in older PLHIV. Paper presented at: Conference on Retroviruses and Opportunistic Infections; March 4-7, 2019; Seattle, WA. http://www.croiwebcasts.org/console/player/41291?mediaType=audio&.  Accessed March 8, 2019.