The association between physical activity and cognition in men with and without HIV infection

A K Monroe; L Zhang; L P Jacobson; M W Plankey; T T Brown; E N Miller; E Martin; J T Becker; A J Levine; A Ragin; N C Sacktor

doi:10.1111/hiv.12490

The association between physical activity and cognition in men with and without HIV infection

HIV Med. 2017 Sep;18(8):555-563. doi: 10.1111/hiv.12490. Epub 2017 Mar 13.

Authors

A K Monroe¹, L Zhang², L P Jacobson², M W Plankey³, T T Brown¹, E N Miller⁴, E Martin⁵, J T Becker⁶, A J Levine⁴, A Ragin⁷, N C Sacktor⁸

Affiliations

¹ Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
² Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
³ Department of Medicine, Georgetown University, Washington, DC, USA.
⁴ Department of Psychiatry and Bio-behavioral Sciences, University of California, Los Angeles, Los Angeles, CA, USA.
⁵ Department of Psychiatry, Rush University Medical Center, Chicago, IL, USA.
⁶ Departments of Psychiatry, Psychology, and Neurology, University of Pittsburgh, Pittsburgh, PA, USA.
⁷ Department of Radiology, Feinberg School of Medicine, Northwestern University, Evanston, IL, USA.
⁸ Department of Neurology, Johns Hopkins Bayview Medical Center, Baltimore, MD.

Abstract

Objectives: HIV-associated neurocognitive disorders are highly prevalent, and physical activity (PA) is a modifiable behaviour that may affect neurocognitive function. Our objective was to determine the association between PA and neurocognitive function and the effect of HIV on this association.

Methods: PA was assessed in the Multicenter AIDS Cohort Study with the International Physical Activity Questionnaire. A neuropsychological test battery assessed global impairment and domain-specific impairment (executive function, speed of processing, working memory, learning, memory, and motor function) every 2 years. Semiannually, the Symbol Digit Modalities Test and Trail Making Test Parts A and B were performed. Adjusted logistic regression models were used to assess the PA-neurocognitive function association. Using longitudinal data, we also assessed the PA category-decline of neurocognitive function association with multivariate simple regression.

Results: Of 601 men, 44% were HIV-infected. Low, moderate, and high PA was reported in 27%, 25%, and 48% of the HIV-infected men vs. 19%, 32% and 49% of the HIV-uninfected men, respectively. High PA was associated with lower odds of impairment of learning, memory, and motor function [odds ratio (OR) ranging from 0.52 to 0.57; P < 0.05 for all]. The high PA-global impairment association OR was 0.63 [95% confidence interval (CI) 0.39, 1.02]. Among HIV-infected men only, across multiple domains, the high PA-impairment association was even more pronounced (OR from 0.27 to 0.49). Baseline high/moderate PA was not associated with decline of any domain score over time. HIV infection was marginally associated with a higher speed of decline in motor function.

Conclusions: A protective effect of high PA on impairment in neurocognitive domains was observed cross-sectionally. Longitudinal PA measurements are needed to elucidate the PA-neurocognitive function relationship over time.

Keywords: HIV; neurocognitive function; neuropsychologic test battery; physical activity.

Publication types

Multicenter Study
Research Support, N.I.H., Extramural

MeSH terms

AIDS Dementia Complex / pathology*
Adult
Aged
Aged, 80 and over
Cognition*
Cross-Sectional Studies
Exercise*
HIV Infections / complications*
Humans
Longitudinal Studies
Male
Mental Health*
Middle Aged
Surveys and Questionnaires
Young Adult

Abstract

Publication types

MeSH terms

Grants and funding