Factors Predicting Detrimental Change in Declarative Memory Among Women With HIV: A Study of Heterogeneity in Cognition
Year: 2020
Type: article
Abstract: Objective: Statistical techniques used to study cognitive function in HIV typically yield normative estimates and can mask the heterogeneity in cognitive trajectories over time. We applied a novel statistical approach to identify clusters of individuals with distinct patterns of change in declarative memory in HIV-seropositive (HIV+) and HIV-seronegative (HIV-) women. Methods: 1731 women from the Women’s Interagency HIV Study, a multi-center, prospective cohort study, completed the Hopkins Verbal Learning Test-Revised (HLVT-R) at > 2 visits. To derive subgroups with similar patterns of decline by HIV-serostatus, we used a mixed-effects framework that modeled the trajectory of multiple declarative memory outcomes over time, while simultaneously clustering individuals. Results: Of the 1731 participants, 1149 were HIV+, (70% Black/African American [AA]; 30% White/Other [W/O]) and 582 were HIV- (68% AA; 32% W/O). Race stratification was necessary to optimize clustering. Among HIV+AA’s, four subgroups emerged: a subgroup with minimal decline, two with accelerated decline, and one with stable but low performance. In HIV- AA, three subgroups emerged: one with minimal decline and two with accelerated decline. In multivariable-adjusted models among HIV+, individuals with accelerated decline were less educated (P<0.001) and more likely to have a history of depression (P<0.001) versus those with minimal decline. Similar subgroups were identified in W/O HIV+ and W/O HIV- participants. Conclusions: We identified clinically meaningful subgroups of women with distinct phenotypes of declarative memory decline, which depend on race and HIV-serostatus using a data driven approach. Identification of underlying mechanisms and risk factors contributing to the observed differences are warranted. More broadly our modeling approach could be other populations to identify risk factors for accelerated cognitive decline and to personalize interventions.
Source: Frontiers in Psychology
Institutions: Johns Hopkins University, Johns Hopkins Medicine, University of Illinois Chicago, Sidney Kimmel Comprehensive Cancer Center, Albert Einstein College of Medicine, Montefiore Medical Center, SUNY Downstate Health Sciences University, Georgetown University Medical Center, University of North Carolina at Chapel Hill, Emory University, University of Alabama at Birmingham, University of Miami, University of California, San Francisco
Language: English
Topic: HIV Research and Treatment
Subfield: Virology
Field: Immunology and Microbiology
Domain: Life Sciences
Open Access status: gold
Estimated APC paid: $2,950
Funders: National Multiple Sclerosis Society, Johns Hopkins University, Georgia Clinical and Translational Science Alliance, National Institutes of Health, University of California, San Francisco, Center for AIDS Research, University of Alabama at Birmingham, National Institute on Alcohol Abuse and Alcoholism, National Institute of Mental Health, National Institute on Drug Abuse, National Cancer Institute, National Institute on Deafness and Other Communication Disorders, National Institute of Allergy and Infectious Diseases, National Institute of Child Health and Human Development, National Institute of Dental and Craniofacial Research, Office of Research on Women's Health, National Center for Advancing Translational Sciences, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Center for AIDS Research, University of North Carolina at Chapel Hill
Awards: G1002715558, G1110103167, Emory WIHS CRS - Longitudinal Cohort, G2840865780, G311558797, G3206421427, The Connie Wofsy Women's HIV Study, Brooklyn Women's Interagency HIV Study (WIHS) V, G3572819748, Miami Womens Interagency HIV Study WIHS, G3869857964, G4371267688, WIHS Data Management and Analysis Center (WDMAC), Southern California Women's Interagency HIV Study Consortium, Cocaine Use and HIV Antiretroviral Therapy Efficacy in the CNS, Chicago WIHS Consortium V (CWC), Washington Women's Interagency HIV/AIDS Study, G5653205272, G5699974340, G5873686156, Clinical and Translational Science Institute, G5900455136, G5938652292, Atlanta Clinical and Translational Science Institute (ACTSI) Renewal, G612407757, Circadian Rhythms and Sleep, Structural Neuroimaging and Depression in People with Multiple Sclerosis, G6300780520, G6384504179, G6937273202, G6944561475, G6990385686, University of North Carolina Womens Interagency HIV Study UNC WIHS, G767062161, G770964534, G775892330, G7807729167, Women's Interagency HIV Study (WIHS-V), G8327600025, G8672865157, G8846374971, UAB-MISS WIHS Cohort, G9000080293, G9000122276, The University of North Carolina Center for AIDS Research, UAB Center for AIDS Research (CFAR), G929137571
OpenAlex ID: W3092928754