Carole Dufouil1, Laura Richert2, Rodolphe Thiébaut2, Mathias Bruyand2, Hélène Amieva2, Frédéric-Antoine Dauchy2, Jean-François Dartigues2, Didier Neau2, Philippe Morlat2, Patrick Dehail2, François Dabis2, Fabrice Bonnet2, Geneviève Chêne2. 1. From INSERM (C.D., L.R., R.T., M.B., H.A., J.-F.D., P.M., P.D., F.D., F.B., G.C.), Centre INSERM U897 and CIC-1401, Bordeaux School of Public Health; University of Bordeaux (C.D., L.R., R.T., M.B., H.A., J.-F.D., P.M., P.D., F.D., F.B., G.C.); and Public Health Department (C.D., L.R., R.T., M.B., F.D., G.C.), Internal Medicine and Infectious Disease Department (F.-A.D., P.M., P.D., F.B.), Neurology Department (J.-F.D.), and Infectious and Tropical Diseases Federation (D.N.), Bordeaux Hospital, France. carole.dufouil@inserm.fr. 2. From INSERM (C.D., L.R., R.T., M.B., H.A., J.-F.D., P.M., P.D., F.D., F.B., G.C.), Centre INSERM U897 and CIC-1401, Bordeaux School of Public Health; University of Bordeaux (C.D., L.R., R.T., M.B., H.A., J.-F.D., P.M., P.D., F.D., F.B., G.C.); and Public Health Department (C.D., L.R., R.T., M.B., F.D., G.C.), Internal Medicine and Infectious Disease Department (F.-A.D., P.M., P.D., F.B.), Neurology Department (J.-F.D.), and Infectious and Tropical Diseases Federation (D.N.), Bordeaux Hospital, France.
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.
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-infectedpatients 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.
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