Elevated Depressive Symptoms Are a Stronger Predictor of Executive Dysfunction in HIV-Infected Women Than in Men

Author: Rubin, Leah H.; Springer, Gayle; Martin, Eileen M.; Seaberg, Eric C.; Sacktor, Ned C.; Levine, Andrew; Valcour, Victor G.; Young, Mary A.; Becker, James T.; Maki, Pauline M.

Description: BACKGROUND: HIV-infected (HIV+) women seem to be more vulnerable to neurocognitive impairment (NCI) than HIV+ men, perhaps in part due to mental health factors. We assessed the association between elevated depressive symptoms and NCI among HIV+ and HIV-uninfected (HIV-) women and men.

SETTING: Women’s Interagency HIV Study and Multicenter AIDS Cohort Study.

METHODS: Eight hundred fifty-eight HIV+ (429 women; 429 men) and 562 HIV- (281 women; 281 men) completed the Center for Epidemiologic Studies Depression (16 cutoff) Scale and measures of psychomotor speed/attention, executive, and motor function over multiple visits (or time points). Women’s Interagency HIV Study and Multicenter AIDS Cohort Study participants were matched according to HIV status, age, race/ethnicity, and education. Generalized linear mixed models were used to examine interactions between biological sex, HIV serostatus, and depression on impairment (T-scores<40) after covariate adjustment.

RESULTS: Despite a higher frequency of depression among men, the association between depression and executive function differed by sex and HIV serostatus. HIV+ women with depression had 5 times the odds of impairment on a measure of executive control and inhibition versus HIV- depressed women and 3 times the odds of impairment on that measure versus HIV+ depressed men. Regardless of group status, depression was associated with greater impairment on processing speed, executive (mental flexibility), and motor function (P’s<0.05).

CONCLUSIONS: Depression contributes to NCI across a broad range of cognitive domains in HIV+ and HIV- individuals, but HIV+ depressed women show greater vulnerabilities in executive function. Treating depression may help to improve cognition in patients with HIV infection.

Subject headings: Adult; Age Factors; Aged; Cognition; Cohort Studies; Depression; Ethnic Groups; Executive Function; Female; HIV Infections; Humans; Male; Mental Health; Middle Aged; Race Factors; Sex Factors; United States; Young Adult

Publication year: 2019

Journal or book title: Journal of Acquired Immune Deficiency Syndromes

Volume: 81

Issue: 3

Pages: 274-283

Find the full text: https://journals.lww.com/jaids/Fulltext/2019/07010/Elevated_Depressive_Symptoms_Are_a_Stronger.5.aspx

Find more like this one (cited by): https://scholar.google.com/scholar?cites=4687917267834464861&as_sdt=5,26&sciodt=0,26&hl=en

Serial number: 3245

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