Neurocognitive impairment in aging people living with HIV; a comparative study of elderly patients attending the University College Hospital Ibadan, Nigeria.

Abstract

Background
Ageing People Living with HIV (PLWH) can experience an exacerbation of age-associated Neurocognitive impairment (NCI) and decline compared to HIV- uninfected counterpart. This study aimed to evaluate ageassociated cognitive impairment in ageing PLWH in contrast to age-matched HIV-uninfected older adults.
Method
A survey of 186 persons (≥60years) was conducted at the University College Hospital, Ibadan Nigeria, in April-June 2018. Participants were selected at ratio 1:2 for HIV-positive and HIV-negative status and age-matched at ±5 years. 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.
Results
Ageing PLWH, had the 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 cases 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 are ≥8years duration of HIV-infection (p=0.032), poor HAARTs-compliance (p=0.039), type-1 HIV (p=0.057) and higher viral-load (p=0.076).
Conclusion
Ageing People living with HIV(PLWH) are more at risk of developing early-onset dementia because of HIV-related factors. Early screening for dementia can be recommended as part of HIV-care plan for adult persons living with HIV in low and middle-income countries like Nigeria.