Predicting Trajectories of Everyday Functioning in Adults Aging with HIV Using Latent Growth Mixture Modeling.

Abstract

As the U.S. population of people with HIV (PWH) ages, PWH exhibit high rates of adverse health outcomes including everyday functioning decline. We aimed to (1) identify trajectories of self-reported everyday functioning and (2) examine baseline predictors (demographics, cognitive domains, psychiatric and medical comorbidities, HIV-disease characteristics) of trajectories among PWH. 742 PWH completed up to five semi-annual visits over two years. Latent growth mixture modeling identified a linear 3-class solution with good statistical fit and interpretability. Most PWH (88%) had good baseline functioning with stability. Two classes had elevated baseline functional declines with worsening (7%) or improvement (5%). Greater depressive symptoms and motor skills impairment predicted higher odds of impaired functioning. Having chronic pulmonary disease increased odds of improvement, which may reflect connection to care, while older age increased odds of worsening. Most aging PWH demonstrate stable everyday functioning; however, interventions for depression and motor skills may improve functioning.