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Abstract
Objective: We investigated the relationship of diabetes and prediabetes with cognitive performances, assessed through raw test and z scores and according to neurocognitive impairment (NCI) classification in a cohort of individuals infected with HIV.
Methods: The ANRS CO3 Aquitaine cohort is a prospective hospital-based cohort of HIV-1–infected patients under routine clinical management in 6 public hospitals in southwestern France. Between 2007 and 2009, an ancillary study consisted of a neuropsychological battery of 10 tests at baseline and 2-year follow-up. The severity of NCI (normal, asymptomatic, mild, HIV dementia) was assessed according to international guidelines.
Results: At baseline (400 patients, 33 with prediabetes, 39 with diabetes), in cross-sectional multivariable analyses, patients with diabetes performed significantly worse on 9 neuropsychological tests that assessed memory, executive functions, attention, psychomotor speed, language, and manual dexterity. Participants with prediabetes had worse performances compared with those who had normal glycemia in 5 tests. The longitudinal analysis of the association between glycemia status at baseline and change in cognitive performances over 2-year follow-up (n = 283) suggested that patients with diabetes also showed a slightly higher decline on 5 of the 10 tests, those involving executive functions and memory functioning. Glycemia status at baseline was not significantly associated with NCI severity in cross-sectional (p = 0.44) and longitudinal (p = 0.64) analyses.
Conclusions: In this hospital-based cohort of people living with HIV, diabetes, but not the other cardiovascular risk factors, is associated with worse cognitive performances in several cognitive domains and with larger decline in fewer domains over the short term.
GLOSSARY
- ANRS=
- Agence Nationale de Recherches sur le Sida et les Hépatites Virales;
- ART=
- antiretroviral treatment;
- BMI=
- body mass index;
- CES-D=
- Center for Epidemiologic Studies–Depression;
- ICD-10=
- International Classification of Diseases, Tenth Revision;
- MetS=
- metabolic syndrome;
- NCI=
- neurocognitive impairment
Footnotes
ANRS CO3 Aquitaine Study Group coinvestigators are listed on the Neurology® Web site at Neurology.org.
Go to Neurology.org for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.
Presented in part at the XIX International AIDS Conference, Washington, DC, July 2012.
Supplemental data at Neurology.org
- Received December 1, 2014.
- Accepted in final form May 21, 2015.
- © 2015 American Academy of Neurology
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