Effects of Malnutrition as a Co-Morbid Factor on Neurocognitive Functioning in HIV Positive Adults in Lusaka, Zambia

Abstract

Objectives: To investigate the effects of malnutrition as a co-morbid factor on neurocognitive functioning in HIV positive adults in Lusaka.

Design: A cross- sectional study consisting of 263 participants. The sample comprised of 109 (40.2 %) males and 162 (59.8%) females with an age range of between 20 and 65 years. Participants` educational level ranged from 5 to 20 years.

Measures: The International Neurobehavioural Test Battery was used to measure neurocognitive functioning. Body Mass Index (BMI), Glucose levels, Protein levels and Haemoglobin levels were used to determine nutritional status.

Results: Haemoglobin has the strongest relationship with global mean T-scores ((β= 0.204, p<0.05). It also accounted for a significant portion of the variance (ΔR² = 0.040, ΔF = 9.252, p< 0.05). When ANOVA was run similar results were obtained. The results indicate that the there is a statistically significant difference on neurocognitive test performance for the 3 levels of haemoglobin (F (2,255) = 5.588, p = 0.004). The results also show that significant effects of malnutrition as a comorbid factor were observed on the following domains: BMI - learning( F (2,262) = 2 533, p = 0.019); Glucose - verbal fluency (F (2,255) = 2 501, p = 0.029);; Hemoglobin - executive functioning( F(2,225) = 2.198, p = 0.034, Recall (F (2,255) = 2.734, p = 0.021) and learning ( F (2,255) = 4.668, p = 0.036).

Conclusion: Results obtained in the study seem to suggest that there is generally an effect of malnutrition as a co-morbid factor on neurocognitive functioning in HIV positive adults in Lusaka particularly in low haemoglobin states. Malnutrition as a co-morbid factor affects a number of cognitive domains and these are learning, verbal fluency, recall, executive functioning.