Changes in cognition precede changes in HRQoL among HIV+ males: Longitudinal analysis of the multicenter AIDS cohort study

Jacob D. Jones*, Taylor Kuhn, Andrew Levine, Ned Sacktor, Cynthia A. Munro, Linda A. Teplin, Gypsyamber D'Souza, Eileen M. Martin, James T. Becker, Eric N. Miller, Charles H. Hinkin

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

20 Scopus citations


Objectives: Despite treatment-related improvements in morbidity and mortality, HIV-1-infected (HIV+) individuals continue to face a wide range of HIV-associated medical and HIV-associated neurocognitive disorders. Little is known about the impact of cognitive impairment on patients' health-related quality of life (HRQoL). To address this, the current study examined the longitudinal relationship between cognitive functioning and HRQoL among HIV+ individuals. Method: The sample consisted of 1,306 HIV+ men enrolled in the Multicenter AIDS Cohort Study. Participants received biannual assessments of cognitive functioning (including tests of processing speed, executive functioning, attention/working memory, motor functioning, learning, and memory) and completed questionnaires assessing HRQoL and depression. Multilevel models were used to examine the longitudinal and cross-lagged relationship between HRQoL and cognition, independent of depression and HIV disease severity. Results: There was a significant relationship between HRQoL and cognitive functioning both between and within subjects. Specifically, individuals who reported better HRQoL reported better cognitive functioning, and longitudinal change in cognition was positively related to change in HRQoL. There was a significant unidirectional-lagged relationship; cognition predicted HRQoL at subsequent visits, but HRQoL did not predict cognitive functioning at subsequent visits. Furthermore, analyses of severity of neurocognitive impairment revealed that transition to a more severe stage of cognitive impairment was associated with a decline in HRQoL. Conclusions: Overall, the current study suggests that changes in HRQoL are partially driven by changes in cognitive functioning.

Original languageEnglish (US)
Pages (from-to)370-378
Number of pages9
Issue number3
StatePublished - Mar 2019


  • Cognition
  • HIV
  • HIV-associated neurocognitive disorder
  • Multilevel modeling
  • Quality of life

ASJC Scopus subject areas

  • Neuropsychology and Physiological Psychology


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