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

doi:10.1037/neu0000530

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

Psychiatry and Behavioral Sciences

Research output: Contribution to journal › Article › peer-review

2 Scopus citations

Abstract

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 language	English (US)
Pages (from-to)	370-378
Number of pages	9
Journal	Neuropsychology
Volume	33
Issue number	3
DOIs	https://doi.org/10.1037/neu0000530
State	Published - Mar 2019

Keywords

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

ASJC Scopus subject areas

Neuropsychology and Physiological Psychology

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10.1037/neu0000530

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Jones, Jacob D. ; Kuhn, Taylor ; Levine, Andrew ; Sacktor, Ned ; Munro, Cynthia A. ; Teplin, Linda A. ; D'Souza, Gypsyamber ; Martin, Eileen M. ; Becker, James T. ; Miller, Eric N. ; Hinkin, Charles H. / Changes in cognition precede changes in HRQoL among HIV+ males : Longitudinal analysis of the multicenter AIDS cohort study. In: Neuropsychology. 2019 ; Vol. 33, No. 3. pp. 370-378.

@article{04a61c50ad9045f0a8894a213deedd82,

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

abstract = "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.",

keywords = "Cognition, HIV, HIV-associated neurocognitive disorder, Multilevel modeling, Quality of life",

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

note = "Funding Information: Data in this article were collected by the Multicenter AIDS Cohort Study (MACS). MACS (principal investigators): Johns Hopkins University Bloomberg School of Public Health (Joseph Margolick), U01-AI35042; Northwestern University (Steven Wolinsky), U01-AI35039; University of California, Los Angeles (Roger Detels, Oto Martinez-Maza), U01-AI35040; University of Pittsburgh (Charles Rinaldo), U01-AI35041; the Center for Analysis and Management of MACS, Johns Hopkins University Bloomberg School of Public Health (Lisa Jacobson, Gypsyamber D{\textquoteright}Souza), UM1-AI35043. The MACS is funded primarily by the National Institute of Allergy and Infectious Diseases, with additional cofunding from the National Cancer Institute, the National Institute on Drug Abuse, and the National Institute of Mental Health (NIMH). Targeted supplemental funding for specific projects was also provided by the National Heart, Lung, and Blood Institute and the National Institute on Deafness and Communication Disorders. MACS data collection is also supported by UL1-TR001079 (Johns Hopkins University ICTR) from the National Center for Advancing Translational Sciences (NCATS), a component of the National Institutes of Health (NIH), and NIH Roadmap for Medical Research. The contents of this publication are solely the responsibility of the authors and do not represent the official views of the NIH, Johns Hopkins University ICTR, or NCATS. The MACS website is http://aidscohortstudy .org. Jacob D. Jones is supported by a NIMH T32 training grant (MH19535).",

year = "2019",

month = mar,

doi = "10.1037/neu0000530",

language = "English (US)",

volume = "33",

pages = "370--378",

journal = "Neuropsychology",

issn = "0894-4105",

publisher = "American Psychological Association Inc.",

number = "3",

}

Changes in cognition precede changes in HRQoL among HIV+ males : Longitudinal analysis of the multicenter AIDS cohort study. / Jones, Jacob D.; Kuhn, Taylor; Levine, Andrew; Sacktor, Ned; Munro, Cynthia A.; Teplin, Linda A.; D'Souza, Gypsyamber; Martin, Eileen M.; Becker, James T.; Miller, Eric N.; Hinkin, Charles H.

In: Neuropsychology, Vol. 33, No. 3, 03.2019, p. 370-378.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - Changes in cognition precede changes in HRQoL among HIV+ males

T2 - Longitudinal analysis of the multicenter AIDS cohort study

AU - Jones, Jacob D.

AU - Kuhn, Taylor

AU - Levine, Andrew

AU - Sacktor, Ned

AU - Munro, Cynthia A.

AU - Teplin, Linda A.

AU - D'Souza, Gypsyamber

AU - Martin, Eileen M.

AU - Becker, James T.

AU - Miller, Eric N.

AU - Hinkin, Charles H.

N1 - Funding Information: Data in this article were collected by the Multicenter AIDS Cohort Study (MACS). MACS (principal investigators): Johns Hopkins University Bloomberg School of Public Health (Joseph Margolick), U01-AI35042; Northwestern University (Steven Wolinsky), U01-AI35039; University of California, Los Angeles (Roger Detels, Oto Martinez-Maza), U01-AI35040; University of Pittsburgh (Charles Rinaldo), U01-AI35041; the Center for Analysis and Management of MACS, Johns Hopkins University Bloomberg School of Public Health (Lisa Jacobson, Gypsyamber D’Souza), UM1-AI35043. The MACS is funded primarily by the National Institute of Allergy and Infectious Diseases, with additional cofunding from the National Cancer Institute, the National Institute on Drug Abuse, and the National Institute of Mental Health (NIMH). Targeted supplemental funding for specific projects was also provided by the National Heart, Lung, and Blood Institute and the National Institute on Deafness and Communication Disorders. MACS data collection is also supported by UL1-TR001079 (Johns Hopkins University ICTR) from the National Center for Advancing Translational Sciences (NCATS), a component of the National Institutes of Health (NIH), and NIH Roadmap for Medical Research. The contents of this publication are solely the responsibility of the authors and do not represent the official views of the NIH, Johns Hopkins University ICTR, or NCATS. The MACS website is http://aidscohortstudy .org. Jacob D. Jones is supported by a NIMH T32 training grant (MH19535).

PY - 2019/3

Y1 - 2019/3

N2 - 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.

AB - 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.

KW - Cognition

KW - HIV

KW - HIV-associated neurocognitive disorder

KW - Multilevel modeling

KW - Quality of life

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