TY - JOUR
T1 - Midlife adiposity predicts cognitive decline in the prospective Multicenter AIDS Cohort Study
AU - Rubin, Leah H.
AU - Gustafson, Deborah
AU - Hawkins, Kellie L.
AU - Zhang, Long
AU - Jacobson, Lisa P.
AU - Becker, James T.
AU - Munro, Cynthia A.
AU - Lake, Jordan E.
AU - Martin, Eileen
AU - Levine, Andrew
AU - Brown, Todd T.
AU - Sacktor, Ned
AU - Erlandson, Kristine M.
N1 - Funding Information:
L.H. Rubin, D. Gustafson, K.L. Hawkins, L. Zhang, L.P. Jacobson, J.T. Becker, and C.A. Munro report no disclosures relevant to the manuscript. J.E. Lake has served as a consultant to Gilead Sciences and Merck and has received research funding from Gilead Sciences. E. Martin and A. Levine report no disclosures relevant to the manuscript. T.T. Brown served as a consultant to Gilead Sciences, Merck, BMS, ViiV Healthcare, Theratechnologies, and EMD-Serono. N. Sacktor reports no disclosures relevant to the manuscript. K.M. Erlandson has served as a consultant to Gilead Sciences and ViiV Healthcare and has received research funding from Gilead Sciences and Merck. Go to Neurology.org/N for full disclosures.
Funding Information:
Research reported in this publication was supported by the National Heart, Lung, and Blood Institute, the National Institute of Immunology, Allergy, and Infectious Disease, and the National Institute of Aging of the NIH under award numbers T32HL116276 to University of Colorado; K24 AI120834 to T.T.B.; NIA K23 AG050260 and R01AG054366 to K.M.E.; K23 AI110532 to J.E.L.; and P30MH075673 to L.H.R., N.S. Data in this manuscript were collected by the Multicenter AIDS Cohort Study (MACS). MACS (Principal Investigators): Johns Hopkins University Bloomberg School of Public Health (Joseph Margolick, Todd Brown), U01-AI35042; Northwestern University (Steven Wolinsky), U01-AI35039; University of California, Los Angeles (Roger Detels, Oto Martinez-Maza), U01-AI35040; University of Pittsburgh (Charles Rinaldo), U01-AI35041; the Center for Analysis and Management of
Funding Information:
MACS, Johns Hopkins University Bloomberg School of Public Health (Lisa Jacobson, Gypsyamber D’Souza), UM1-AI35043. The MACS is funded primarily by the National Institute of Allergy and Infectious Diseases, with additional cofunding from the National Cancer Institute, the National Institute on Drug Abuse, and the National Institute of Mental Health. Targeted supplemental funding for specific projects was also provided by the National Heart, Lung, and Blood Institute and the National Institute on Deafness and Communication Disorders. MACS data collection is also supported by UL1-TR001079 (JHU ICTR) from the National Center for Advancing Translational Sciences (NCATS), a component of the NIH, and NIH Roadmap for Medical Research. The contents of this publication are solely the responsibility of the authors and do not represent the official views of the NIH, Johns Hopkins ICTR, or NCATS. The MACS website is located at aidscohortstudy.org/.
Publisher Copyright:
© American Academy of Neurology.
PY - 2019/7/16
Y1 - 2019/7/16
N2 - ObjectiveObesity is a common, modifiable cardiovascular and cerebrovascular risk factor. Among people with HIV, obesity may contribute to multisystem dysregulation including cognitive impairment. We examined body mass index (BMI) and central obesity (waist circumference [WC]) in association with domain-specific cognitive function and 10-year cognitive decline in men with HIV infection (MWH) vs HIV-uninfected (HIV-) men.MethodsA total of 316 MWH and 656 HIV-Multicenter AIDS Cohort Study participants ≥40 years at baseline, with neuropsychological testing every 2 years and concurrent BMI and WC measurements, were included. MWH were included if taking ≥2 antiretroviral agents and had HIV-1 RNA <400 copies/mL at >80% of visits. Mixed-effects models included all visits from 1996 to 2015, stratified by HIV serostatus, and adjusted for sociodemographic, behavioral, and clinical characteristics. At baseline and follow-up, 8% of MWH and 15% of HIV-men and 41% of MWH and 56% of HIV-men were ≥60 years, respectively.ResultsCross-sectionally, higher BMI was inversely associated with motor function in MWH and HIV-men, and attention/working memory in HIV-men. WC was inversely associated with motor function in MWH and HIV-men. Longitudinal associations indicated an obese BMI was associated with a less steep decline in motor function in MWH whereas in HIV-men, obesity was associated with a greater decline in motor function, learning, and memory. WC, or central obesity, showed similar patterns of associations.ConclusionHigher adiposity is associated with lower cognition cross-sectionally and greater cognitive decline, particularly in HIV-men. Overweight and obesity may be important predictors of neurologic outcomes and avenues for prevention and intervention.
AB - ObjectiveObesity is a common, modifiable cardiovascular and cerebrovascular risk factor. Among people with HIV, obesity may contribute to multisystem dysregulation including cognitive impairment. We examined body mass index (BMI) and central obesity (waist circumference [WC]) in association with domain-specific cognitive function and 10-year cognitive decline in men with HIV infection (MWH) vs HIV-uninfected (HIV-) men.MethodsA total of 316 MWH and 656 HIV-Multicenter AIDS Cohort Study participants ≥40 years at baseline, with neuropsychological testing every 2 years and concurrent BMI and WC measurements, were included. MWH were included if taking ≥2 antiretroviral agents and had HIV-1 RNA <400 copies/mL at >80% of visits. Mixed-effects models included all visits from 1996 to 2015, stratified by HIV serostatus, and adjusted for sociodemographic, behavioral, and clinical characteristics. At baseline and follow-up, 8% of MWH and 15% of HIV-men and 41% of MWH and 56% of HIV-men were ≥60 years, respectively.ResultsCross-sectionally, higher BMI was inversely associated with motor function in MWH and HIV-men, and attention/working memory in HIV-men. WC was inversely associated with motor function in MWH and HIV-men. Longitudinal associations indicated an obese BMI was associated with a less steep decline in motor function in MWH whereas in HIV-men, obesity was associated with a greater decline in motor function, learning, and memory. WC, or central obesity, showed similar patterns of associations.ConclusionHigher adiposity is associated with lower cognition cross-sectionally and greater cognitive decline, particularly in HIV-men. Overweight and obesity may be important predictors of neurologic outcomes and avenues for prevention and intervention.
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U2 - 10.1212/WNL.0000000000007779
DO - 10.1212/WNL.0000000000007779
M3 - Article
C2 - 31201294
AN - SCOPUS:85069949054
SN - 0028-3878
VL - 93
SP - E261-E271
JO - Neurology
JF - Neurology
IS - 3
ER -