艾滋病毒和注射吸毒老年人的认知功能和死亡率。

IF 3.1 2区 医学 Q3 IMMUNOLOGY
AIDS Pub Date : 2025-07-15 Epub Date: 2025-03-03 DOI:10.1097/QAD.0000000000004169
Damani A Piggott, Shruti H Mehta, Leah H Rubin, Jing Sun, Sean X Leng, Gregory D Kirk
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引用次数: 0

摘要

目的:认知障碍和虚弱是艾滋病毒感染者(PLWH)中普遍存在的关键衰老相关表型。然而,在有注射吸毒史(PWID)的艾滋病毒感染者和有艾滋病毒风险的人群中,关于认知功能决定因素的数据有限,或者关于这一人群中认知功能和虚弱与死亡率的交叉关系的数据有限。设计/方法:在与静脉注射相关的艾滋病(ALIVE)队列中,对携带和不携带艾滋病毒的PWID进行标准认知评估。脆弱性评估使用5 Fried物理脆弱性表型标准。根据IL-6和可溶性TNF-α受体-1数据构建炎症指数评分。采用Cox比例风险模型估计死亡风险。结果:519名ALIVE参与者中,中位年龄为52岁,41%为PLWH。危险饮酒和老年与处理速度、运动功能和整体认知功能的降低显著相关。在多变量模型中,处理速度、运动功能和整体认知功能的降低与死亡率的增加显著相关。整体认知功能下降和虚弱与死亡率独立相关。处理速度、运动功能、执行功能和整体认知功能的降低与炎症的加剧显著相关。结论:认知功能下降是HIV和PWID感染者死亡的重要预测因素,与虚弱、HIV疾病分期和合并症无关。针对PLWH和PWID的认知功能和虚弱的干预措施,包括针对炎症途径的干预措施,可能会改善这些人群的衰老结果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Cognitive function and mortality among persons aging with HIV and injection drug use.

Objective: Cognitive impairment and frailty are critical, aging-related phenotypes prevalent among people with HIV (PWH). Yet, limited data exist isolating the determinants of cognitive function among persons with a history of injection drug use (PWID) with and at risk for HIV, or on the intersecting relationship of cognitive function and frailty with mortality in this population.

Design/methods: Standard cognitive assessments were performed among PWID with and without HIV in the AIDS Linked to the IntraVenous Experience (ALIVE) cohort. Frailty was assessed using the five Fried physical frailty phenotype criteria. An inflammatory index score was constructed from IL-6 and soluble TNF-α receptor-1 data. Cox proportional hazards models were utilized to estimate mortality risk.

Results: Among 516 ALIVE participants, the median age was 52 years, and 41% were PWH. Hazardous alcohol use and older age were significantly associated with reductions in processing speed, motor function, and global cognitive function. In multivariable models, reduced processing speed, motor function, and global cognitive function were significantly associated with increased mortality. Reduced global cognitive function and frailty were independently associated with mortality. Reduced processing speed, motor function, executive function, and global cognitive function were significantly associated with heightened inflammation.

Conclusion: Reduced cognitive function is a significant predictor of death among PWH and PWID, independent of frailty, HIV disease stage, and comorbidity. Interventions that target both cognitive function and frailty, including those targeting inflammation pathways, among PWH and PWID may improve aging outcomes for these populations.

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来源期刊
AIDS
AIDS 医学-病毒学
CiteScore
5.90
自引率
5.30%
发文量
478
审稿时长
3 months
期刊介绍: ​​​​​​​​​​​​​​​​​Publishing the very latest ground breaking research on HIV and AIDS. Read by all the top clinicians and researchers, AIDS has the highest impact of all AIDS-related journals. With 18 issues per year, AIDS guarantees the authoritative presentation of significant advances. The Editors, themselves noted international experts who know the demands of your work, are committed to making AIDS the most distinguished and innovative journal in the field. Submitted articles undergo a preliminary review by the editor. Some articles may be returned to authors without further consideration. Those being considered for publication will undergo further assessment and peer-review by the editors and those invited to do so from a reviewer pool.
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