Physiological effects of physical activity on neurocognitive function in people living with HIV: A systematic review of intervention and observational studies

Abstract

The inadequacy of antiretroviral therapy in the treatment of HIV-associated neurocognitive disorders paves a way for regular physical activity as a lifestyle modification alternative. However, uncertainty exists among scholars regarding the use of physical activity as a means of managing cognitive disorders among HIV-seropositive individuals. The objective of the review was to examine the potential therapeutic value of physical activity intervention in the rehabilitation of people living with HIV (PLWHIV) experiencing cognitive disorders. Undertaken in this study was a systematic literature review by narrative and quantitative synthesis examining studies from 2000 to 2019. Data sources for the review included the following electronic databases: Medline, PubMed, Cochrane Library, CINAHL (The Cumulative Index to Nursing and Allied Health Literature), Academic Search Complete, PsycINFO and relevant reference lists. The eligibility criteria for the selected studies included in the review were interventional and observational studies, which investigated the interaction of physical activity and cognitive function in adult PLWHIV. Fourteen studies met the inclusion criteria. The study outcomes were cognitive function, aerobic fitness and sociodemographic characteristics. Meta-analyses were executed using RevMan 5.3 and MedCalc, with alpha set at 0.05. A total of 2516 PLWHIV with a mean age of 54±8 years and education, 13±2 years participated in the studies reviewed. Men constituted a greater percentage (60%) of the study participants. Physical activity was not superior to control over cognitive function (Z=0.86; p=0.39; Tau²=61.79 and I²=94%). However, there was a significant correlation between physical activity and neurocognitive function (r=0.26; p<0.05). It was concluded that physical activity was not superior to control over cognitive function in PLWHIV with no reported cognitive deficit.