Neurocognitive Impairment in Aging People Living With HIV: A Comparative Study of Elderly Patients Attending the University College Hospital Ibadan, Nigeria

Abstract

Ageing People Living with HIV (PLWH) can experience an exacerbation of age-associated neurocognitive impairment (NCI) and decline compared to their HIV- uninfected counterparts. This study aimed to evaluate age-associated cognitive impairment in ageing PLWH in contrast to age-matched HIV-uninfected older adults. A survey of 186 persons (≥60years) was conducted at the University College Hospital, Ibadan Nigeria between April and June 2018. Participants were selected at a ratio 1:2 for HIV-positive and HIV-negative status respectively, and age-matched at ±5years. The Montreal Cognitive Assessment (MoCA), and Trail Making Test (TMT) A & B were conducted for cognitive assessment and other clinical data were collected and analyzed with SPSS 23. Ageing PLWH, had poorer cognitive ability (p=0.000) and a higher burden of chronic non-communicable diseases (NCDs) (p=0.000). Many (71%) of the PLWH, had cognitive-impairment, with 32 cases of Mild Cognitive Impairment (MCI) and 12 individuals diagnosed with dementia. Of the HIV-infected cohort, the cognitively-impaired, ageing PLWH had higher viral-load and poorer HAARTs-compliance. Risk factors for cognitive impairment among ageing-PLWH were: greater than 8 years duration of HIV-infection (p=0.032) and poor HAARTs-compliance (p=0.039), while type-1 HIV (p=0.057) and higher viral-load (p=0.076) showed a trend towards significance.   Ageing People living with HIV(PLWH) are more at risk of developing early-onset dementia because of HIV-related factors. Early screening for dementia should be recommended as part of HIV-care plan for adult persons living with HIV in low and middle-income countries like Nigeria