BACKGROUND: The risk for psychiatric and neurocognitive disorders among middle-aged and older individuals with HIV infection has not been well characterized. METHODS: The Veterans Aging Cohort 5-Site Study enrolled 1803 patients (1047 HIV-positive) from VA infectious disease and general medicine clinics from September 2001 to June 2002. A convenience subset of 10 patients from each site (n = 50) was consented for formal neurocognitive and psychiatric (NCP) testing. Data from this subset were linked to the larger sample. RESULTS: Kappa scores for agreement beyond chance were fair for available measures when compared with formal NCP testing. Using available measures, depressive symptoms (PHQ-9 and provider reported), alcohol abuse or dependence (ICD-9 codes), and drug abuse or dependence (DAST-10) decreased with age in HIV-negative subjects (P trend <0.05) but did not among HIV-positive subjects (P > 0.05). HIV-positive subjects demonstrated higher prevalence of these conditions with increasing age when compared to HIV-negative subjects. Patient report of memory problems increased with age among both groups after excluding those reporting symptoms of depression (PHQ-9e > or = 10). CONCLUSION: Available measures were no substitute for formal NCP testing. Older HIV-positive veterans demonstrate greater prevalence of depressive symptoms, alcohol abuse or dependence, and drug abuse or dependence than age-matched, HIV-negative veterans. Both groups reported increased memory problems with advancing age. This preliminary work suggests a substantial prevalence of psychiatric and neurocognitive problems among middle-aged and older HIV-infected individuals.
BACKGROUND: The risk for psychiatric and neurocognitive disorders among middle-aged and older individuals with HIV infection has not been well characterized. METHODS: The Veterans Aging Cohort 5-Site Study enrolled 1803 patients (1047 HIV-positive) from VA infectious disease and general medicine clinics from September 2001 to June 2002. A convenience subset of 10 patients from each site (n = 50) was consented for formal neurocognitive and psychiatric (NCP) testing. Data from this subset were linked to the larger sample. RESULTS: Kappa scores for agreement beyond chance were fair for available measures when compared with formal NCP testing. Using available measures, depressive symptoms (PHQ-9 and provider reported), alcohol abuse or dependence (ICD-9 codes), and drug abuse or dependence (DAST-10) decreased with age in HIV-negative subjects (P trend <0.05) but did not among HIV-positive subjects (P > 0.05). HIV-positive subjects demonstrated higher prevalence of these conditions with increasing age when compared to HIV-negative subjects. Patient report of memory problems increased with age among both groups after excluding those reporting symptoms of depression (PHQ-9e > or = 10). CONCLUSION: Available measures were no substitute for formal NCP testing. Older HIV-positive veterans demonstrate greater prevalence of depressive symptoms, alcohol abuse or dependence, and drug abuse or dependence than age-matched, HIV-negative veterans. Both groups reported increased memory problems with advancing age. This preliminary work suggests a substantial prevalence of psychiatric and neurocognitive problems among middle-aged and older HIV-infected individuals.
Authors: Chiao-Wen Lan; David A Fiellin; Declan T Barry; Kendall J Bryant; Adam J Gordon; E Jennifer Edelman; Julie R Gaither; Stephen A Maisto; Brandon D L Marshall Journal: Am J Addict Date: 2015-12-22
Authors: Joseph K Lim; Janet P Tate; Shawn L Fultz; Joseph L Goulet; Joseph Conigliaro; Kendall J Bryant; Adam J Gordon; Cynthia Gibert; David Rimland; Matthew Bidwell Goetz; Marina B Klein; David A Fiellin; Amy C Justice; Vincent Lo Re Journal: Clin Infect Dis Date: 2014-02-25 Impact factor: 9.079
Authors: Vincent Lo Re; Bret Zeldow; Michael J Kallan; Janet P Tate; Dena M Carbonari; Sean Hennessy; Jay R Kostman; Joseph K Lim; Matthew Bidwell Goetz; Robert Gross; Amy C Justice; Jason A Roy Journal: Pharmacoepidemiol Drug Saf Date: 2017-07-19 Impact factor: 2.890
Authors: Linda G Marc; Whitney R Henderson; Astrid Desrosiers; Marcia A Testa; Samuel E Jean; Eniko Edit Akom Journal: J Gen Intern Med Date: 2014-08-05 Impact factor: 5.128
Authors: Jesse R Fann; Donna L Berry; Seth Wolpin; Mary Austin-Seymour; Nigel Bush; Barbara Halpenny; William B Lober; Ruth McCorkle Journal: Psychooncology Date: 2009-01 Impact factor: 3.894