title: Neuropsychological test profile differences between young and old human immunodeficiency virus-positive individuals.
abstract: Human immunodeficiency virus (HIV) dementia remains as an important cause of neurological morbidity among HIV-seropositive (HIV+) individuals. Differences in the neuropsychological profiles between older and younger HIV+ individuals have not been examined extensively. The objective of this study was to examine the neuropsychological test performance between old and young HIV+ individuals (a) with and without cognitive impairment (total cohort) and (b) with dementia. One hundred thirty-three older (age >or= 50 years) HIV+ individuals and 121 younger (age 20 to 39 years) HIV+ individuals were evaluated with a standardized neuropsychological test battery. Differences between age groups in the mean z score for each neuropsychological test were determined. The older HIV+ (total) cohort had greater impairment in tests of verbal memory (P = .006), visual memory (P < .002), verbal fluency (P = .001), and psychomotor speed (P < .001) compared to the young HIV+ (total) cohort. After adjusting for differences in education, older HIV+ patients with dementia (n = 31) had a greater deficit in the Trail Making test Part B (P = 0.02) compared to younger HIV+ patients with dementia (n = 15). Age was associated with lower performance in tests of memory, executive functioning, and motor performance in older HIV+ individuals with and without cognitive impairment (total cohort), compared to younger HIV+ individuals. Among HIV+ patients with dementia, age may be associated with greater impairment in a test of executive functioning. These differences could be a result of advanced age itself or age-associated comorbidities such as coexisting cerebrovascular or neurodegenerative disease.
authors.affiliation: Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA. sacktor@jhmi.edu
authors.forename: Ned
authors.initials: N
authors.lastname: Sacktor
authors.forename: Richard
authors.initials: R
authors.lastname: Skolasky
authors.forename: Ola A
authors.initials: OA
authors.lastname: Selnes
authors.forename: Michael
authors.initials: M
authors.lastname: Watters
authors.forename: Pamela
authors.initials: P
authors.lastname: Poff
authors.forename: Bruce
authors.initials: B
authors.lastname: Shiramizu
authors.forename: Cecilia
authors.initials: C
authors.lastname: Shikuma
authors.forename: Victor
authors.initials: V
authors.lastname: Valcour
mesh_terms: D015526:AIDS Dementia Complex / Q000175:diagnosis* / Q000453:epidemiology*; D000328:Adult; D017677:Age Distribution; D003071:Cognition; D003072:Cognition Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000821:virology; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D008568:Memory; D008875:Middle Aged; D009017:Morbidity; D009483:Neuropsychological Tests; D012307:Risk Factors; D014706:Verbal Learning