Depression, lifestyle factors and cognitive function in people living with HIV and comparable HIV-negative controls

the Pharmacokinetic and Clinical Observations in People over Fifty (POPPY) study

doi:10.1111/hiv.12714

Depression, lifestyle factors and cognitive function in people living with HIV and comparable HIV-negative controls

the Pharmacokinetic and Clinical Observations in People over Fifty (POPPY) study

Clinical Services Unit

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

24 Citations (Scopus)

Abstract

Objectives: We investigated whether differences in cognitive performance between people living with HIV (PLWH) and comparable HIV-negative people were mediated or moderated by depressive symptoms and lifestyle factors. Methods: A cross-sectional study of 637 ‘older’ PLWH aged ≥ 50 years, 340 ‘younger’ PLWH aged < 50 years and 276 demographically matched HIV-negative controls aged ≥ 50 years enrolled in the Pharmacokinetic and Clinical Observations in People over Fifty (POPPY) study was performed. Cognitive function was assessed using a computerized battery (CogState). Scores were standardized into Z-scores [mean = 0; standard deviation (SD) = 1] and averaged to obtain a global Z-score. Depressive symptoms were evaluated via the Patient Health Questionnaire (PHQ-9). Differences between the three groups and the effects of depression, sociodemographic factors and lifestyle factors on cognitive performance were evaluated using median regression. All analyses accounted for age, gender, ethnicity and level of education. Results: After adjustment for sociodemographic factors, older and younger PLWH had poorer overall cognitive scores than older HIV-negative controls (P < 0.001 and P = 0.006, respectively). Moderate or severe depressive symptoms were more prevalent in both older (27%; P < 0.001) and younger (21%; P < 0.001) PLWH compared with controls (8%). Depressive symptoms (P < 0.001) and use of hashish (P = 0.01) were associated with lower cognitive function; alcohol consumption (P = 0.02) was associated with better cognitive scores. After further adjustment for these factors, the difference between older PLWH and HIV-negative controls was no longer significant (P = 0.08), while that between younger PLWH and older HIV-negative controls remained significant (P = 0.01). Conclusions: Poorer cognitive performances in PLWH compared with HIV-negative individuals were, in part, mediated by the greater prevalence of depressive symptoms and recreational drug use reported by PLWH.

Original language	English
Pages (from-to)	274-285
Number of pages	12
Journal	HIV Medicine
Volume	20
Issue number	4
DOIs	https://doi.org/10.1111/hiv.12714
Publication status	Published - Apr 2019

Bibliographical note

Funding Information:
We thank all participants in the study. Financial disclosure: This study was funded by investigator initiated grants from BMS, Gilead Sciences, Janssen, Merck and ViiV Healthcare (EudraCT Number: 2012-003581-40; Sponsor Protocol Number: CRO1992). The study was also supported by the National Institute for Health Research (NIHR) Biomedical Research Centre based at Imperial College Healthcare NHS Trust and Imperial College London and by an NIHR Senior Investigator Award to Professor C. A. Sabin. MB has received speaking fees from Gilead, MSD/Merck and Janssen, advisory fees from ViiV, Gilead and MSD/Merck, honoraria from Gilead for speakers' bureaus and a travel grant from Gilead and has been the principal investigator in clinical trials sponsored by Gilead, ViiV, Mylan, Janssen and Bristol-Meyers Squibb. FAP has received research grants from Gilead Sciences and ViiV Healthcare, and fees from Gilead Sciences, ViiV Healthcare, MSD and Janssen for membership of advisory boards and speaker panels and/or for the preparation of educational materials. PWGM has received funding for membership of advisory boards and speaker panels, and preparation of educational materials, and/or research grants to his institution from Gilead Sciences, ViiV Healthcare, BMS, MSD, Abbvie and Janssen-Cilag. JA has received grants, personal fees and nonfinancial support from Gilead Sciences, MSD, Janssen and BMS, and nonfinancial support from ViiV.

Funding Information:
Financial disclosure: This study was funded by investigator initiated grants from BMS, Gilead Sciences, Jans-sen, Merck and ViiV Healthcare (EudraCT Number: 2012-003581-40; Sponsor Protocol Number: CRO1992). The study was also supported by the National Institute for Health Research (NIHR) Biomedical Research Centre based at Imperial College Healthcare NHS Trust and Imperial College London and by an NIHR Senior Investigator Award to Professor C. A. Sabin. MB has received speaking fees from Gilead, MSD/Merck and Janssen, advisory fees from ViiV, Gilead and MSD/Merck, honoraria from Gilead for speakers’ bureaus and a travel grant from Gilead and has been the principal investigator in clinical trials sponsored by Gilead, ViiV, Mylan, Janssen and Bristol-Meyers Squibb. FAP has received research grants from Gilead Sciences and ViiV Healthcare, and fees from Gilead Sciences, ViiV Healthcare, MSD and Janssen for membership of advisory boards and speaker panels and/ or for the preparation of educational materials. PWGM has received funding for membership of advisory boards and speaker panels, and preparation of educational materials, and/or research grants to his institution from Gilead Sciences, ViiV Healthcare, BMS, MSD, Abbvie and Jans-sen-Cilag. JA has received grants, personal fees and nonfinancial support from Gilead Sciences, MSD, Janssen and BMS, and nonfinancial support from ViiV.

Publisher Copyright:
© 2019 The Authors. HIV Medicine published by John Wiley & Sons Ltd on behalf of British HIV Association

Keywords

HIV
HIV-associated neurocognitive disorders
cognitive disorder
cognitive function
depression
people living with HIV

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1111/hiv.12714

Cite this

@article{74dc0313a42447d7ba8167f0c060d52a,

title = "Depression, lifestyle factors and cognitive function in people living with HIV and comparable HIV-negative controls",

abstract = "Objectives: We investigated whether differences in cognitive performance between people living with HIV (PLWH) and comparable HIV-negative people were mediated or moderated by depressive symptoms and lifestyle factors. Methods: A cross-sectional study of 637 {\textquoteleft}older{\textquoteright} PLWH aged ≥ 50 years, 340 {\textquoteleft}younger{\textquoteright} PLWH aged < 50 years and 276 demographically matched HIV-negative controls aged ≥ 50 years enrolled in the Pharmacokinetic and Clinical Observations in People over Fifty (POPPY) study was performed. Cognitive function was assessed using a computerized battery (CogState). Scores were standardized into Z-scores [mean = 0; standard deviation (SD) = 1] and averaged to obtain a global Z-score. Depressive symptoms were evaluated via the Patient Health Questionnaire (PHQ-9). Differences between the three groups and the effects of depression, sociodemographic factors and lifestyle factors on cognitive performance were evaluated using median regression. All analyses accounted for age, gender, ethnicity and level of education. Results: After adjustment for sociodemographic factors, older and younger PLWH had poorer overall cognitive scores than older HIV-negative controls (P < 0.001 and P = 0.006, respectively). Moderate or severe depressive symptoms were more prevalent in both older (27%; P < 0.001) and younger (21%; P < 0.001) PLWH compared with controls (8%). Depressive symptoms (P < 0.001) and use of hashish (P = 0.01) were associated with lower cognitive function; alcohol consumption (P = 0.02) was associated with better cognitive scores. After further adjustment for these factors, the difference between older PLWH and HIV-negative controls was no longer significant (P = 0.08), while that between younger PLWH and older HIV-negative controls remained significant (P = 0.01). Conclusions: Poorer cognitive performances in PLWH compared with HIV-negative individuals were, in part, mediated by the greater prevalence of depressive symptoms and recreational drug use reported by PLWH.",

keywords = "HIV, HIV-associated neurocognitive disorders, cognitive disorder, cognitive function, depression, people living with HIV",

author = "{the Pharmacokinetic and Clinical Observations in People over Fifty (POPPY) study} and {De Francesco}, D. and J. Underwood and E. Bagkeris and M. Boffito and Post, {F. A.} and Mallon, {P. W.G.} and Vera, {J. H.} and I. Williams and J. Anderson and M. Johnson and Sabin, {C. A.} and A. Winston and Daphne Babalis and Laura Burgess and Paddy Mallon and Memory Sachikonye and David Asboe and Lucy Garvey and Anton Pozniak and Amanda Clarke and Andrew Bexley and Celia Richardson and Sarah Kirk and Rebecca Gleig and Margherita Bracchi and Nicole Pagani and Maddalena Cerrone and Daniel Bradshaw and Francesca Ferretti and Chris Higgs and Elisha Seah and Stephen Fletcher and Michelle Anthonipillai and Ashley Moyes and Katie Deats and Irtiza Syed and Clive Matthews and Peter Fernando and Chido Chiwome and Shane Hardwick and Sifiso Mguni and Rebecca Clark and Rhiannon Nevin-Dolan and Sambasivarao Pelluri and Lucy Campbell and Selin Yurdakul and Sara Okumu and Louise Pollard and Beatriz Santana-Suarez and Alan Macken",

note = "Funding Information: We thank all participants in the study. Financial disclosure: This study was funded by investigator initiated grants from BMS, Gilead Sciences, Janssen, Merck and ViiV Healthcare (EudraCT Number: 2012-003581-40; Sponsor Protocol Number: CRO1992). The study was also supported by the National Institute for Health Research (NIHR) Biomedical Research Centre based at Imperial College Healthcare NHS Trust and Imperial College London and by an NIHR Senior Investigator Award to Professor C. A. Sabin. MB has received speaking fees from Gilead, MSD/Merck and Janssen, advisory fees from ViiV, Gilead and MSD/Merck, honoraria from Gilead for speakers' bureaus and a travel grant from Gilead and has been the principal investigator in clinical trials sponsored by Gilead, ViiV, Mylan, Janssen and Bristol-Meyers Squibb. FAP has received research grants from Gilead Sciences and ViiV Healthcare, and fees from Gilead Sciences, ViiV Healthcare, MSD and Janssen for membership of advisory boards and speaker panels and/or for the preparation of educational materials. PWGM has received funding for membership of advisory boards and speaker panels, and preparation of educational materials, and/or research grants to his institution from Gilead Sciences, ViiV Healthcare, BMS, MSD, Abbvie and Janssen-Cilag. JA has received grants, personal fees and nonfinancial support from Gilead Sciences, MSD, Janssen and BMS, and nonfinancial support from ViiV. Funding Information: Financial disclosure: This study was funded by investigator initiated grants from BMS, Gilead Sciences, Jans-sen, Merck and ViiV Healthcare (EudraCT Number: 2012-003581-40; Sponsor Protocol Number: CRO1992). The study was also supported by the National Institute for Health Research (NIHR) Biomedical Research Centre based at Imperial College Healthcare NHS Trust and Imperial College London and by an NIHR Senior Investigator Award to Professor C. A. Sabin. MB has received speaking fees from Gilead, MSD/Merck and Janssen, advisory fees from ViiV, Gilead and MSD/Merck, honoraria from Gilead for speakers{\textquoteright} bureaus and a travel grant from Gilead and has been the principal investigator in clinical trials sponsored by Gilead, ViiV, Mylan, Janssen and Bristol-Meyers Squibb. FAP has received research grants from Gilead Sciences and ViiV Healthcare, and fees from Gilead Sciences, ViiV Healthcare, MSD and Janssen for membership of advisory boards and speaker panels and/ or for the preparation of educational materials. PWGM has received funding for membership of advisory boards and speaker panels, and preparation of educational materials, and/or research grants to his institution from Gilead Sciences, ViiV Healthcare, BMS, MSD, Abbvie and Jans-sen-Cilag. JA has received grants, personal fees and nonfinancial support from Gilead Sciences, MSD, Janssen and BMS, and nonfinancial support from ViiV. Publisher Copyright: {\textcopyright} 2019 The Authors. HIV Medicine published by John Wiley & Sons Ltd on behalf of British HIV Association",

year = "2019",

month = apr,

doi = "10.1111/hiv.12714",

language = "English",

volume = "20",

pages = "274--285",

journal = "HIV Medicine",

issn = "1464-2662",

publisher = "wiley",

number = "4",

}

TY - JOUR

T1 - Depression, lifestyle factors and cognitive function in people living with HIV and comparable HIV-negative controls

AU - the Pharmacokinetic and Clinical Observations in People over Fifty (POPPY) study

AU - De Francesco, D.

AU - Underwood, J.

AU - Bagkeris, E.

AU - Boffito, M.

AU - Post, F. A.

AU - Mallon, P. W.G.

AU - Vera, J. H.

AU - Williams, I.

AU - Anderson, J.

AU - Johnson, M.

AU - Sabin, C. A.

AU - Winston, A.

AU - Babalis, Daphne

AU - Burgess, Laura

AU - Mallon, Paddy

AU - Sachikonye, Memory

AU - Asboe, David

AU - Garvey, Lucy

AU - Pozniak, Anton

AU - Clarke, Amanda

AU - Bexley, Andrew

AU - Richardson, Celia

AU - Kirk, Sarah

AU - Gleig, Rebecca

AU - Bracchi, Margherita

AU - Pagani, Nicole

AU - Cerrone, Maddalena

AU - Bradshaw, Daniel

AU - Ferretti, Francesca

AU - Higgs, Chris

AU - Seah, Elisha

AU - Fletcher, Stephen

AU - Anthonipillai, Michelle

AU - Moyes, Ashley

AU - Deats, Katie

AU - Syed, Irtiza

AU - Matthews, Clive

AU - Fernando, Peter

AU - Chiwome, Chido

AU - Hardwick, Shane

AU - Mguni, Sifiso

AU - Clark, Rebecca

AU - Nevin-Dolan, Rhiannon

AU - Pelluri, Sambasivarao

AU - Campbell, Lucy

AU - Yurdakul, Selin

AU - Okumu, Sara

AU - Pollard, Louise

AU - Santana-Suarez, Beatriz

AU - Macken, Alan

N1 - Funding Information: We thank all participants in the study. Financial disclosure: This study was funded by investigator initiated grants from BMS, Gilead Sciences, Janssen, Merck and ViiV Healthcare (EudraCT Number: 2012-003581-40; Sponsor Protocol Number: CRO1992). The study was also supported by the National Institute for Health Research (NIHR) Biomedical Research Centre based at Imperial College Healthcare NHS Trust and Imperial College London and by an NIHR Senior Investigator Award to Professor C. A. Sabin. MB has received speaking fees from Gilead, MSD/Merck and Janssen, advisory fees from ViiV, Gilead and MSD/Merck, honoraria from Gilead for speakers' bureaus and a travel grant from Gilead and has been the principal investigator in clinical trials sponsored by Gilead, ViiV, Mylan, Janssen and Bristol-Meyers Squibb. FAP has received research grants from Gilead Sciences and ViiV Healthcare, and fees from Gilead Sciences, ViiV Healthcare, MSD and Janssen for membership of advisory boards and speaker panels and/or for the preparation of educational materials. PWGM has received funding for membership of advisory boards and speaker panels, and preparation of educational materials, and/or research grants to his institution from Gilead Sciences, ViiV Healthcare, BMS, MSD, Abbvie and Janssen-Cilag. JA has received grants, personal fees and nonfinancial support from Gilead Sciences, MSD, Janssen and BMS, and nonfinancial support from ViiV. Funding Information: Financial disclosure: This study was funded by investigator initiated grants from BMS, Gilead Sciences, Jans-sen, Merck and ViiV Healthcare (EudraCT Number: 2012-003581-40; Sponsor Protocol Number: CRO1992). The study was also supported by the National Institute for Health Research (NIHR) Biomedical Research Centre based at Imperial College Healthcare NHS Trust and Imperial College London and by an NIHR Senior Investigator Award to Professor C. A. Sabin. MB has received speaking fees from Gilead, MSD/Merck and Janssen, advisory fees from ViiV, Gilead and MSD/Merck, honoraria from Gilead for speakers’ bureaus and a travel grant from Gilead and has been the principal investigator in clinical trials sponsored by Gilead, ViiV, Mylan, Janssen and Bristol-Meyers Squibb. FAP has received research grants from Gilead Sciences and ViiV Healthcare, and fees from Gilead Sciences, ViiV Healthcare, MSD and Janssen for membership of advisory boards and speaker panels and/ or for the preparation of educational materials. PWGM has received funding for membership of advisory boards and speaker panels, and preparation of educational materials, and/or research grants to his institution from Gilead Sciences, ViiV Healthcare, BMS, MSD, Abbvie and Jans-sen-Cilag. JA has received grants, personal fees and nonfinancial support from Gilead Sciences, MSD, Janssen and BMS, and nonfinancial support from ViiV. Publisher Copyright: © 2019 The Authors. HIV Medicine published by John Wiley & Sons Ltd on behalf of British HIV Association

PY - 2019/4

Y1 - 2019/4

N2 - Objectives: We investigated whether differences in cognitive performance between people living with HIV (PLWH) and comparable HIV-negative people were mediated or moderated by depressive symptoms and lifestyle factors. Methods: A cross-sectional study of 637 ‘older’ PLWH aged ≥ 50 years, 340 ‘younger’ PLWH aged < 50 years and 276 demographically matched HIV-negative controls aged ≥ 50 years enrolled in the Pharmacokinetic and Clinical Observations in People over Fifty (POPPY) study was performed. Cognitive function was assessed using a computerized battery (CogState). Scores were standardized into Z-scores [mean = 0; standard deviation (SD) = 1] and averaged to obtain a global Z-score. Depressive symptoms were evaluated via the Patient Health Questionnaire (PHQ-9). Differences between the three groups and the effects of depression, sociodemographic factors and lifestyle factors on cognitive performance were evaluated using median regression. All analyses accounted for age, gender, ethnicity and level of education. Results: After adjustment for sociodemographic factors, older and younger PLWH had poorer overall cognitive scores than older HIV-negative controls (P < 0.001 and P = 0.006, respectively). Moderate or severe depressive symptoms were more prevalent in both older (27%; P < 0.001) and younger (21%; P < 0.001) PLWH compared with controls (8%). Depressive symptoms (P < 0.001) and use of hashish (P = 0.01) were associated with lower cognitive function; alcohol consumption (P = 0.02) was associated with better cognitive scores. After further adjustment for these factors, the difference between older PLWH and HIV-negative controls was no longer significant (P = 0.08), while that between younger PLWH and older HIV-negative controls remained significant (P = 0.01). Conclusions: Poorer cognitive performances in PLWH compared with HIV-negative individuals were, in part, mediated by the greater prevalence of depressive symptoms and recreational drug use reported by PLWH.

AB - Objectives: We investigated whether differences in cognitive performance between people living with HIV (PLWH) and comparable HIV-negative people were mediated or moderated by depressive symptoms and lifestyle factors. Methods: A cross-sectional study of 637 ‘older’ PLWH aged ≥ 50 years, 340 ‘younger’ PLWH aged < 50 years and 276 demographically matched HIV-negative controls aged ≥ 50 years enrolled in the Pharmacokinetic and Clinical Observations in People over Fifty (POPPY) study was performed. Cognitive function was assessed using a computerized battery (CogState). Scores were standardized into Z-scores [mean = 0; standard deviation (SD) = 1] and averaged to obtain a global Z-score. Depressive symptoms were evaluated via the Patient Health Questionnaire (PHQ-9). Differences between the three groups and the effects of depression, sociodemographic factors and lifestyle factors on cognitive performance were evaluated using median regression. All analyses accounted for age, gender, ethnicity and level of education. Results: After adjustment for sociodemographic factors, older and younger PLWH had poorer overall cognitive scores than older HIV-negative controls (P < 0.001 and P = 0.006, respectively). Moderate or severe depressive symptoms were more prevalent in both older (27%; P < 0.001) and younger (21%; P < 0.001) PLWH compared with controls (8%). Depressive symptoms (P < 0.001) and use of hashish (P = 0.01) were associated with lower cognitive function; alcohol consumption (P = 0.02) was associated with better cognitive scores. After further adjustment for these factors, the difference between older PLWH and HIV-negative controls was no longer significant (P = 0.08), while that between younger PLWH and older HIV-negative controls remained significant (P = 0.01). Conclusions: Poorer cognitive performances in PLWH compared with HIV-negative individuals were, in part, mediated by the greater prevalence of depressive symptoms and recreational drug use reported by PLWH.

KW - HIV

KW - HIV-associated neurocognitive disorders

KW - cognitive disorder

KW - cognitive function

KW - depression

KW - people living with HIV

UR - http://www.scopus.com/inward/record.url?scp=85061257855&partnerID=8YFLogxK

U2 - 10.1111/hiv.12714

DO - 10.1111/hiv.12714

M3 - Article

C2 - 30734983

AN - SCOPUS:85061257855

SN - 1464-2662

VL - 20

SP - 274

EP - 285

JO - HIV Medicine

JF - HIV Medicine

IS - 4

ER -

Depression, lifestyle factors and cognitive function in people living with HIV and comparable HIV-negative controls

Abstract

Bibliographical note

Keywords

UN SDGs

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