Frailty and prefrailty phenotypes increase the odds of abnormal cognitive impairment screens in people with HIV.


Journal

AIDS (London, England)
ISSN: 1473-5571
Titre abrégé: AIDS
Pays: England
ID NLM: 8710219

Informations de publication

Date de publication:
15 11 2023
Historique:
medline: 26 10 2023
pubmed: 3 8 2023
entrez: 3 8 2023
Statut: ppublish

Résumé

Evaluate whether prefrail and frail people with HIV (PWH) have a higher risk of cognitive impairment on screens. Analysis of PWH 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) less than 26 was compared in frail/prefrail versus robust PWH. A total of 503 PWH 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. A total of 294 (58.5%) PWH had a MoCA score less than 26; 182 (36%) a MoCA score 23 or less. Frailty, prefrailty and robustness were found in 13.1, 63.6 and 23.3% participants, respectively. PWH with a MoCA less than 26 had a significantly higher risk of being frail/prefrail, this before [odds ratio (OR) = 2.31; 95% confidence interval (CI) 1.50-3.57], and after adjustment for confounders (OR = 1.80; 95% CI 1.07-3.01). The risk of being frail/prefrail in patients with a MoCA 23 or less was higher (adjusted OR = 2.75; 95% CI 1.46-5.16). Other factors independently associated with a MoCA less than 26 were older age, birth outside of France and a lower education level and being diabetic. Abnormal MoCA screens were frequent in our cohort of PWH aged 70 or older with controlled HIV disease. Cognitive impairment should be systematically screened in frail/prefrail PWH. Frailty/prefrailty, diabetes and social factors, but not HIV-related factors, are important determinants of cognitive function in PWH with controlled disease.

Identifiants

pubmed: 37534690
doi: 10.1097/QAD.0000000000003681
pii: 00002030-990000000-00318
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

2161-2168

Informations de copyright

Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.

Références

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Auteurs

Alain Makinson (A)

Infectious Disease Department & INSERM U175- CHU La Colombière, University of Montpellier, Montpellier.

Clotilde Allavena (C)

Service de Maladies Infectieuses, UE 1413, CHU de Nantes, Université Nantes, Nantes.

Xian Abulizi (X)

Department of Public Health and Epidemiology, AP-HP, Bicêtre Hospital, Paris-Saclay University, & INSERM CESP U1018, Le Kremlin Bicêtre.

Laurence Slama (L)

Infectious Diseases Hôtel Dieu Hospital, APHP, Paris, France & Centre de Recherche épidémiologie et StatistiqueS Université de Paris Cité (CRESS-UMR1153), France.

Antoine Cases (A)

Department of Public Health and Epidemiology, AP-HP, Bicêtre Hospital, Paris-Saclay University, & INSERM CESP U1018, Le Kremlin Bicêtre.

Marion Bourgey Trouillet (MB)

Infectious Disease Department, CHU La Colombière, University of Montpellier, Montpellier.

Guillaume Martin-Blondel (G)

Service des Maladies Infectieuses et Tropicales, CHU de Toulouse& Institut Toulousain des Maladies Infectieuses et Inflammatoires (Infinity) INSERM UMR1291 - CNRS UMR5051 - Université Toulouse III.

Christian Geny (C)

Department of Geriatrics, MUSE Montpellier University, Montpellier.

Pascale Leclercq (P)

Infectious Diseases Department, CHU de Grenoble Alpes, La Tronche.

Charles Cazanave (C)

Infectious Disease Department & UMR 5234 CNRS, Microbiologie Fondamentale et Pathogénicité, Antimicrobial Resistance in Mycoplasmas and Gram-Negative Bacteria, Bordeaux University Hospital.

Fabrice Bonnet (F)

University of Bordeaux, National Institute for Health and Medical Research (INSERM) UMR 1219, Research Institute for Sustainable Development (IRD) EMR 271, Bordeaux Population Health Centre & CHU de Bordeaux, Saint-André Hospital, Service de Médecine Interne et Maladies Infectieuses, Bordeaux, Cedex.

Alissa Naqvi (A)

CHU de Nice Archet 1 Service de Maladies Infectieuses et Tropicales, Nice.

Perla David-Chevallier (P)

Service de médecine interne et d'immunologie clinique- AP-HP. Université Paris Saclay - Hôpital Béclère-Le Kremlin Bicêtre, FR.

Cédric Arvieux (C)

Département des Maladies Infectieuses, Centre Hospitalier et Universitaire de Rennes, Rennes.

Christine Katlama (C)

Sorbonne University Infectious Diseases Department APHP, Hôpital Pitié Salpêtrière, Paris.

André Cabie (A)

PCCEI, Univ Montpellier, INSERM, EFS, Univ Antilles, Montpellier, France, CIC Antilles Guyane, INSERM CIC1424, Fort-de-France, France.

Valérie Andriantsoanirina (V)

Department of Public Health and Epidemiology, AP-HP, Bicêtre Hospital, Paris-Saclay University, & INSERM CESP U1018, Le Kremlin Bicêtre.

Hubert Blain (H)

Department of Geriatrics, MUSE Montpellier University, Montpellier.

Laurence Meyer (L)

Department of Public Health and Epidemiology, AP-HP, Bicêtre Hospital, Paris-Saclay University, & INSERM CESP U1018, Le Kremlin Bicêtre.

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