Heavy Alcohol Use and Age Effects on HIV-Associated Neurocognitive Function

Ronald A Cohen; Joseph M Gullett; Eric C Porges; Adam J Woods; Damon G Lamb; Vaughn E Bryant; Mikayla McAdams; Karen Tashima; Robert Cook; Kendall Bryant; Mollie Monnig; Christopher W Kahler; Peter M Monti

doi:10.1111/acer.13915

Heavy Alcohol Use and Age Effects on HIV-Associated Neurocognitive Function

Alcohol Clin Exp Res. 2019 Jan;43(1):147-157. doi: 10.1111/acer.13915. Epub 2018 Dec 16.

Authors

Ronald A Cohen^{1

2}, Joseph M Gullett^{1

2}, Eric C Porges^{1

2}, Adam J Woods^{1

2}, Damon G Lamb^{3

4}, Vaughn E Bryant^{1

2}, Mikayla McAdams⁵, Karen Tashima⁵, Robert Cook⁶, Kendall Bryant⁷, Mollie Monnig⁸, Christopher W Kahler⁸, Peter M Monti⁸

Affiliations

¹ Center for Cognitive Aging and Memory , University of Florida, Gainesville, Florida.
² Department of Clinical and Health Psychology , University of Florida, Gainesville, Florida.
³ Department of Psychiatry , University of Florida, Gainesville, Florida.
⁴ Malcom Randall VA Medical Center , Gainesville, Florida.
⁵ Department of Infectious Medicine , The Miriam Hospital, Alpert College of Medicine, Brown University, Providence, Rhode Island.
⁶ Department of Epidemiology , University of Florida, Gainesville, Florida.
⁷ National Institute on Alcohol Abuse and Alcoholism, Bethesda, Maryland.
⁸ Department of Behavioral Sciences , School of Public Health, Brown University, Providence, Rhode Island.

Abstract

Background: There is growing concern about the health impact of heavy alcohol use in people infected with human immunodeficiency virus (HIV+). Mixed findings of past studies regarding the cognitive impact of alcohol use in HIV+ adults have been mixed, with inconsistent evidence that alcohol consumption exacerbates HIV-associated brain dysfunction. This study examined contributions of current heavy drinking, lifetime alcohol use disorder (AUD), and age to cognitive deficits in HIV+ adults, and relative to other HIV-associated clinical factors.

Methods: Cognitive performance of HIV+ adults (n = 104) was assessed, and comparisons were made between heavy current to nonheavy drinkers (NIAAA criteria), lifetime AUD versus no-AUD, and older (>50 years) versus younger participants. Hierarchical regression analyses were conducted to examine the association between cognitive performance and current heavy drinking, lifetime AUD, and older age, while also correcting for HIV clinical factors and history of other substance use.

Results: Individuals reporting current heavy drinking and meeting criteria for lifetime AUD demonstrated the greatest degree of deficits across multiple cognitive domains. Deficits were greatest among HIV+ adults with lifetime AUD, and older age was also associated with weaker cognitive performance. Lifetime AUD and older age independently exhibited stronger associations with cognitive performance than HIV clinical factors (e.g., viral load, current CD4, and nadir CD4) or past opiate and cocaine use.

Conclusions: Current heavy drinking and lifetime AUD adversely affect cognitive function in HIV+ adults. Greatest deficits existed when there was a history of AUD and continued current heavy drinking, indicating that past AUD continues to have an adverse impact and should not be ignored. That alcohol use was more strongly associated with cognitive performance than HIV clinical factors underscore clinical importance of targeting reduction in heavy alcohol consumption in HIV+ adults.

Keywords: Aging; Alcohol Use Disorder; Cognition; Current Alcohol Consumption; Human Immunodeficiency Virus.

Publication types

Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

MeSH terms

Aging / psychology*
Alcohol Drinking / epidemiology*
Alcoholism / epidemiology*
Cognition
Cognitive Dysfunction / epidemiology*
Comorbidity
Female
HIV Infections / epidemiology*
Humans
Male
Middle Aged
Risk Factors

Abstract

Publication types

MeSH terms

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