Implications of vascular depression for successful cognitive aging in HIV Disease

Andrea I Mustafa; Ilex Beltran-Najera; Darrian Evans; Alexandria Bartlett; Vonetta M Dotson; Steven Paul Woods

doi:10.1007/s13365-024-01201-2

Implications of vascular depression for successful cognitive aging in HIV Disease

J Neurovirol. 2024 Mar 28. doi: 10.1007/s13365-024-01201-2. Online ahead of print.

Authors

Andrea I Mustafa¹, Ilex Beltran-Najera¹, Darrian Evans¹, Alexandria Bartlett², Vonetta M Dotson², Steven Paul Woods³

Affiliations

¹ Department of Psychology, University of Houston, 3695 Cullen Blvd, 126 Heyne Bldg (Ste. 239d), Houston, TX, 77204, USA.
² Department of Psychology and c Gerontology Institute, Georgia State University, P.O. Box 5010, Atlanta, GA, 30302, USA.
³ Department of Psychology, University of Houston, 3695 Cullen Blvd, 126 Heyne Bldg (Ste. 239d), Houston, TX, 77204, USA. spwoods@uh.edu.

PMID: 38546936
DOI: 10.1007/s13365-024-01201-2

Abstract

Although older adults with HIV are at high risk for mild neurocognitive disorders, a subset experience successful cognitive aging (SCA). HIV is associated with an increased risk of vascular depression (VasDep), which can affect cognitive and daily functioning. The current study examined whether VasDep impedes SCA among older adults with HIV. 136 persons with HIV aged 50 years and older were classified as either SCA+ (n = 37) or SCA- (n = 99) based on a battery of demographically adjusted neurocognitive tests and self-reported cognitive symptoms. Participants were also stratified on the presence of vascular disease (e.g., hypertension) and current depression as determined by the Composite International Diagnostic Interview and the Depression/Dejection scale of the Profile of Mood States. A Cochran-Armitage test revealed a significant additive effect of vascular disease and depression on SCA in this sample of older adults with HIV (z = 4.13, p <.0001). Individuals with VasDep had the lowest frequency of SCA+ (0%), which differed significantly from the group with only vascular disease (30%, OR = 0.04, CI = 0.002,0.68)) and the group with neither vascular disease nor depression (47% OR = 0.02, CI = 0.33,0.001). Findings were not confounded by demographics, HIV disease severity, or other psychiatric and medical factors (ps > 0.05). These data suggest that presence of VasDep may be a barrier to SCA in older adults with HIV disease. Prospective, longitudinal studies with neuroimaging-based operationalizations of VasDep are needed to further clarify this risk factor's role in the maintenance of cognitive and brain health in persons with HIV disease.

Keywords: Cardiovascular; Geropsychology; Infectious disease; Mood disorder; Neurocognitive disorder; Positive psychology.

Abstract

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