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Midlife adiposity predicts cognitive decline in the prospective Multicenter AIDS Cohort Study

Year: 2019
Type: article
Abstract: OBJECTIVE: Obesity is a common, modifiable cardiovascular and cerebrovascular risk factor. Among people with HIV, obesity may contribute to multisystem dysregulation including cognitive impairment. We examined body mass index (BMI) and central obesity (waist circumference [WC]) in association with domain-specific cognitive function and 10-year cognitive decline in men with HIV infection (MWH) vs HIV-uninfected (HIV-) men. METHODS: A total of 316 MWH and 656 HIV- Multicenter AIDS Cohort Study participants ≥40 years at baseline, with neuropsychological testing every 2 years and concurrent BMI and WC measurements, were included. MWH were included if taking ≥2 antiretroviral agents and had HIV-1 RNA <400 copies/mL at >80% of visits. Mixed-effects models included all visits from 1996 to 2015, stratified by HIV serostatus, and adjusted for sociodemographic, behavioral, and clinical characteristics. At baseline and follow-up, 8% of MWH and 15% of HIV- men and 41% of MWH and 56% of HIV- men were ≥60 years, respectively. RESULTS: Cross-sectionally, higher BMI was inversely associated with motor function in MWH and HIV- men, and attention/working memory in HIV- men. WC was inversely associated with motor function in MWH and HIV- men. Longitudinal associations indicated an obese BMI was associated with a less steep decline in motor function in MWH whereas in HIV- men, obesity was associated with a greater decline in motor function, learning, and memory. WC, or central obesity, showed similar patterns of associations. CONCLUSION: Higher adiposity is associated with lower cognition cross-sectionally and greater cognitive decline, particularly in HIV- men. Overweight and obesity may be important predictors of neurologic outcomes and avenues for prevention and intervention.
Source: Neurology
DOI: 10.1212/wnl.0000000000007779
Authors: Leah H. Rubin, Deborah Gustafson, Kellie L. Hawkins, Long Zhang, Lisa P. Jacobson, James T. Becker, Cynthia A. Munro, Jordan E. Lake, Eileen Martin, Andrew Levine, Todd T. Brown, Ned Sacktor, Kristine M. Erlandson
Institutions: Rush University Medical Center, Johns Hopkins University, University of California, Los Angeles, University of Pittsburgh, SUNY Downstate Health Sciences University, Johns Hopkins Medicine, Denver Public Health, The University of Texas Health Science Center at Houston
Language: English
Field: Medicine
Open Access status: bronze
Funders: National Institute of Immunology, National Institutes of Health, University of California, Los Angeles, National Institute on Aging, National Heart, Lung, and Blood Institute, National Institute of Mental Health, National Cancer Institute, National Institute of Allergy and Infectious Diseases, National Center for Advancing Translational Sciences
Awards: G192128497, Pitavastatin to REduce Physical Function Impairment and FRailty in HIV (PREPARE), Natural History of AIDS in Homosexual Men, The Impact of HIV and Aging on Physical Function and the Somatopause., Translational Research in Neuro-AIDS and Mental Health, Multicenter AIDS Cohort Study - Part B (Baltimore Center), JHU Center for the Advancement of HIV Neurotherapeutics (JHU CAHN), Clinical Research Sites for the MACS/WIHS Combined Cohort Study (MACS/WIHS-CCS) - Baltimore/Wash DC Center
OpenAlex ID: W2952779155
FWCI: 6.455
Cites: 49
Cited by: 43
Related to: 10