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- Title
Disparities in Metabolic Syndrome and Neurocognitive Function Among Older Hispanics/Latinos with Human Immunodeficiency Virus.
- Authors
Marquine, María J.; Kamalyan, Lily; Zlatar, Zvinka Z.; Yassai-Gonzalez, David; Perez-Tejada, Alán; Umlauf, Anya; Al-Rousan, Tala; González, Verónica; Breton, Jordana; Guareña, Lesley A.; Brody, Lilla; Cherner, Mariana; Ellis, Ronald J.; Zúñiga, Maria Luisa; Mungas, Dan M.; Moore, Raeanne C.; Moore, David J.; Wojna, Valerie; Hall, Rasheeda K.; Franklin Jr, Donald R.
- Abstract
Neurocognitive impairment and metabolic syndrome (MetS) are prevalent in persons with HIV (PWH). We examined disparities in HIV-associated neurocognitive function between Hispanic and non-Hispanic White older PWH, and the role of MetS in explaining these disparities. Participants included 116 community-dwelling PWH aged 50–75 years enrolled in a cohort study in southern California [58 Hispanic (53% Spanish speaking) and 58 age-comparable non-Hispanic White; overall group: age: M = 57.9, standard deviation (SD) = 5.7; education (years): M = 13, SD = 3.4; 83% male, 58% AIDS, 94% on antiretroviral therapy]. Global neurocognition was derived from T-scores adjusted for demographics (age, education, sex, ethnicity, language) on a battery of 10 cognitive tests. MetS was ascertained via standard criteria that considered central obesity, and fasting elevated triglycerides, low high-density lipoprotein cholesterol and elevated glucose, or medical treatment for these conditions. Covariates examined included sociodemographic, psychiatric, substance use and HIV disease characteristics. Compared with non-Hispanic Whites, Hispanics showed worse global neurocognitive function (Cohen's d = 0.56, p < 0.05) and had higher rates of MetS (38% vs. 56%, p < 0.05). A stepwise regression model including ethnicity and significant covariates showed Hispanic ethnicity was the sole significant predictor of worse global neurocognition (B = −3.82, SE = 1.27, p < 0.01). A model also including MetS showed that both Hispanic ethnicity (B = −3.39, SE = 1.31, p = 0.01) and MetS (B = −2.73, SE = 1.31, p = 0.04) were independently associated with worse neurocognition. In conclusion, findings indicate that increased MetS is associated with worse neurocognitive function in both Hispanic and non-Hispanic White older PWH, but does not explain neurocognitive disparities. MetS remains an important target for intervention efforts to ameliorate neurocognitive dysfunction among diverse older PWH.
- Subjects
CALIFORNIA; OBESITY risk factors; METABOLIC syndrome risk factors; COGNITION disorder risk factors; RISK assessment; HDL cholesterol; SUBSTANCE abuse; CROSS-sectional method; PHYSICAL diagnosis; SELF-evaluation; STATISTICAL models; MEXICAN Americans; COMMUNICATIVE competence; INDEPENDENT living; ACCULTURATION; T-test (Statistics); HYPERLIPIDEMIA; RESEARCH funding; EXECUTIVE function; HISPANIC Americans; MENTAL illness; COGNITIVE processing speed; BLOOD collection; ENZYME-linked immunosorbent assay; FISHER exact test; LOGISTIC regression analysis; MULTIPLE regression analysis; SEX distribution; WHITE people; DESCRIPTIVE statistics; CARDIOVASCULAR diseases risk factors; REVERSE transcriptase polymerase chain reaction; CLASSIFICATION of mental disorders; CHI-squared test; SYMPTOMS; AGE distribution; PSYCHOLOGY of HIV-positive persons; RACE; ATTENTION; ODDS ratio; NEUROPSYCHOLOGICAL tests; MEMORY; WESTERN immunoblotting; SPANISH language; HEALTH equity; TRIGLYCERIDES; INTELLIGENCE tests; PSYCHOLOGICAL tests; ENGLISH language; DATA analysis software; CONFIDENCE intervals; REGRESSION analysis; COGNITION; BIOMARKERS; WELL-being; SOCIAL classes; POVERTY; EDUCATIONAL attainment; DISEASE risk factors; OLD age
- Publication
AIDS Patient Care & STDs, 2024, Vol 38, Issue 5, p195
- ISSN
1087-2914
- Publication type
Article
- DOI
10.1089/apc.2024.0043