Cognitive impairment in older adults with HIV: : A case-control study.

Abstract

Background: The introduction of antiretroviral therapies for HIV infection has increased life expectancy. However, this advance has increased the prevalence of cognitive impairment (CI) among older adults. Aim: To establish the relationship between chronic HIV and the development of CI in patients over 50 years of age at the Adolfo López Mateos Regional Hospital, Mexico. Methodology: A case-control study was conducted involving 110 patients over the age of 50, 55 in the case group and 55 in the control group (HIV-). The Montreal Cognitive Assessment (MoCA) was used to evaluate the presence of CI. Results: The prevalence of CI was higher in the HIV+ group (63.6 vs. 21.8%, p=0.001), with mean MoCA scores of 24.25 and 26.24 for cases and controls, respectively. The odds ratio (OR) adjusted for the presence of CI in HIV+ patients was 4.84 (95% CI: 2.04-11.45, p < 0.001). Conclusion: HIV infection is significantly associated with cognitive impairment, more pronounced in older patients, those with lower education levels, and those with prolonged infection. The bivariate analysis showed a direct relationship between HIV and CI, while adjustment for clinical variables highlighted the complexity of the interaction of comorbidities. The MoCA assessment revealed global impairment, underscoring the need for integrated strategies that include viral suppression and management of comorbidities and neuroinflammation.