title: Diabetes and cognitive decline in a French cohort of patients infected with HIV-1.
abstract: OBJECTIVE
  We investigated the relationship of diabetes and prediabetes with cognitive performances, assessed through raw test and z scores and according to neurocognitive impairment (NCI) classification in a cohort of individuals infected with HIV.
  
  
  METHODS
  The ANRS CO3 Aquitaine cohort is a prospective hospital-based cohort of HIV-1-infected patients under routine clinical management in 6 public hospitals in southwestern France. Between 2007 and 2009, an ancillary study consisted of a neuropsychological battery of 10 tests at baseline and 2-year follow-up. The severity of NCI (normal, asymptomatic, mild, HIV dementia) was assessed according to international guidelines.
  
  
  RESULTS
  At baseline (400 patients, 33 with prediabetes, 39 with diabetes), in cross-sectional multivariable analyses, patients with diabetes performed significantly worse on 9 neuropsychological tests that assessed memory, executive functions, attention, psychomotor speed, language, and manual dexterity. Participants with prediabetes had worse performances compared with those who had normal glycemia in 5 tests. The longitudinal analysis of the association between glycemia status at baseline and change in cognitive performances over 2-year follow-up (n = 283) suggested that patients with diabetes also showed a slightly higher decline on 5 of the 10 tests, those involving executive functions and memory functioning. Glycemia status at baseline was not significantly associated with NCI severity in cross-sectional (p = 0.44) and longitudinal (p = 0.64) analyses.
  
  
  CONCLUSIONS
  In this hospital-based cohort of people living with HIV, diabetes, but not the other cardiovascular risk factors, is associated with worse cognitive performances in several cognitive domains and with larger decline in fewer domains over the short term.
authors.affiliation: From INSERM (C.D., L.R., R.T., M.B., H.A., J.-F.D., P.M., P.D., F.D., F.B., G.C.), Centre INSERM U897 and CIC-1401, Bordeaux School of Public Health; University of Bordeaux (C.D., L.R., R.T., M.B., H.A., J.-F.D., P.M., P.D., F.D., F.B., G.C.); and Public Health Department (C.D., L.R., R.T., M.B., F.D., G.C.), Internal Medicine and Infectious Disease Department (F.-A.D., P.M., P.D., F.B.), Neurology Department (J.-F.D.), and Infectious and Tropical Diseases Federation (D.N.), Bordeaux Hospital, France. carole.dufouil@inserm.fr.
authors.forename: Carole
authors.initials: C
authors.lastname: Dufouil
authors.affiliation: From INSERM (C.D., L.R., R.T., M.B., H.A., J.-F.D., P.M., P.D., F.D., F.B., G.C.), Centre INSERM U897 and CIC-1401, Bordeaux School of Public Health; University of Bordeaux (C.D., L.R., R.T., M.B., H.A., J.-F.D., P.M., P.D., F.D., F.B., G.C.); and Public Health Department (C.D., L.R., R.T., M.B., F.D., G.C.), Internal Medicine and Infectious Disease Department (F.-A.D., P.M., P.D., F.B.), Neurology Department (J.-F.D.), and Infectious and Tropical Diseases Federation (D.N.), Bordeaux Hospital, France.
authors.forename: Laura
authors.initials: L
authors.lastname: Richert
authors.affiliation: From INSERM (C.D., L.R., R.T., M.B., H.A., J.-F.D., P.M., P.D., F.D., F.B., G.C.), Centre INSERM U897 and CIC-1401, Bordeaux School of Public Health; University of Bordeaux (C.D., L.R., R.T., M.B., H.A., J.-F.D., P.M., P.D., F.D., F.B., G.C.); and Public Health Department (C.D., L.R., R.T., M.B., F.D., G.C.), Internal Medicine and Infectious Disease Department (F.-A.D., P.M., P.D., F.B.), Neurology Department (J.-F.D.), and Infectious and Tropical Diseases Federation (D.N.), Bordeaux Hospital, France.
authors.forename: Rodolphe
authors.initials: R
authors.lastname: Thiébaut
authors.affiliation: From INSERM (C.D., L.R., R.T., M.B., H.A., J.-F.D., P.M., P.D., F.D., F.B., G.C.), Centre INSERM U897 and CIC-1401, Bordeaux School of Public Health; University of Bordeaux (C.D., L.R., R.T., M.B., H.A., J.-F.D., P.M., P.D., F.D., F.B., G.C.); and Public Health Department (C.D., L.R., R.T., M.B., F.D., G.C.), Internal Medicine and Infectious Disease Department (F.-A.D., P.M., P.D., F.B.), Neurology Department (J.-F.D.), and Infectious and Tropical Diseases Federation (D.N.), Bordeaux Hospital, France.
authors.forename: Mathias
authors.initials: M
authors.lastname: Bruyand
authors.affiliation: From INSERM (C.D., L.R., R.T., M.B., H.A., J.-F.D., P.M., P.D., F.D., F.B., G.C.), Centre INSERM U897 and CIC-1401, Bordeaux School of Public Health; University of Bordeaux (C.D., L.R., R.T., M.B., H.A., J.-F.D., P.M., P.D., F.D., F.B., G.C.); and Public Health Department (C.D., L.R., R.T., M.B., F.D., G.C.), Internal Medicine and Infectious Disease Department (F.-A.D., P.M., P.D., F.B.), Neurology Department (J.-F.D.), and Infectious and Tropical Diseases Federation (D.N.), Bordeaux Hospital, France.
authors.forename: Hélène
authors.initials: H
authors.lastname: Amieva
authors.affiliation: From INSERM (C.D., L.R., R.T., M.B., H.A., J.-F.D., P.M., P.D., F.D., F.B., G.C.), Centre INSERM U897 and CIC-1401, Bordeaux School of Public Health; University of Bordeaux (C.D., L.R., R.T., M.B., H.A., J.-F.D., P.M., P.D., F.D., F.B., G.C.); and Public Health Department (C.D., L.R., R.T., M.B., F.D., G.C.), Internal Medicine and Infectious Disease Department (F.-A.D., P.M., P.D., F.B.), Neurology Department (J.-F.D.), and Infectious and Tropical Diseases Federation (D.N.), Bordeaux Hospital, France.
authors.forename: Frédéric-Antoine
authors.initials: FA
authors.lastname: Dauchy
authors.affiliation: From INSERM (C.D., L.R., R.T., M.B., H.A., J.-F.D., P.M., P.D., F.D., F.B., G.C.), Centre INSERM U897 and CIC-1401, Bordeaux School of Public Health; University of Bordeaux (C.D., L.R., R.T., M.B., H.A., J.-F.D., P.M., P.D., F.D., F.B., G.C.); and Public Health Department (C.D., L.R., R.T., M.B., F.D., G.C.), Internal Medicine and Infectious Disease Department (F.-A.D., P.M., P.D., F.B.), Neurology Department (J.-F.D.), and Infectious and Tropical Diseases Federation (D.N.), Bordeaux Hospital, France.
authors.forename: Jean-François
authors.initials: JF
authors.lastname: Dartigues
authors.affiliation: From INSERM (C.D., L.R., R.T., M.B., H.A., J.-F.D., P.M., P.D., F.D., F.B., G.C.), Centre INSERM U897 and CIC-1401, Bordeaux School of Public Health; University of Bordeaux (C.D., L.R., R.T., M.B., H.A., J.-F.D., P.M., P.D., F.D., F.B., G.C.); and Public Health Department (C.D., L.R., R.T., M.B., F.D., G.C.), Internal Medicine and Infectious Disease Department (F.-A.D., P.M., P.D., F.B.), Neurology Department (J.-F.D.), and Infectious and Tropical Diseases Federation (D.N.), Bordeaux Hospital, France.
authors.forename: Didier
authors.initials: D
authors.lastname: Neau
authors.affiliation: From INSERM (C.D., L.R., R.T., M.B., H.A., J.-F.D., P.M., P.D., F.D., F.B., G.C.), Centre INSERM U897 and CIC-1401, Bordeaux School of Public Health; University of Bordeaux (C.D., L.R., R.T., M.B., H.A., J.-F.D., P.M., P.D., F.D., F.B., G.C.); and Public Health Department (C.D., L.R., R.T., M.B., F.D., G.C.), Internal Medicine and Infectious Disease Department (F.-A.D., P.M., P.D., F.B.), Neurology Department (J.-F.D.), and Infectious and Tropical Diseases Federation (D.N.), Bordeaux Hospital, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Morlat
authors.affiliation: From INSERM (C.D., L.R., R.T., M.B., H.A., J.-F.D., P.M., P.D., F.D., F.B., G.C.), Centre INSERM U897 and CIC-1401, Bordeaux School of Public Health; University of Bordeaux (C.D., L.R., R.T., M.B., H.A., J.-F.D., P.M., P.D., F.D., F.B., G.C.); and Public Health Department (C.D., L.R., R.T., M.B., F.D., G.C.), Internal Medicine and Infectious Disease Department (F.-A.D., P.M., P.D., F.B.), Neurology Department (J.-F.D.), and Infectious and Tropical Diseases Federation (D.N.), Bordeaux Hospital, France.
authors.forename: Patrick
authors.initials: P
authors.lastname: Dehail
authors.affiliation: From INSERM (C.D., L.R., R.T., M.B., H.A., J.-F.D., P.M., P.D., F.D., F.B., G.C.), Centre INSERM U897 and CIC-1401, Bordeaux School of Public Health; University of Bordeaux (C.D., L.R., R.T., M.B., H.A., J.-F.D., P.M., P.D., F.D., F.B., G.C.); and Public Health Department (C.D., L.R., R.T., M.B., F.D., G.C.), Internal Medicine and Infectious Disease Department (F.-A.D., P.M., P.D., F.B.), Neurology Department (J.-F.D.), and Infectious and Tropical Diseases Federation (D.N.), Bordeaux Hospital, France.
authors.forename: François
authors.initials: F
authors.lastname: Dabis
authors.affiliation: From INSERM (C.D., L.R., R.T., M.B., H.A., J.-F.D., P.M., P.D., F.D., F.B., G.C.), Centre INSERM U897 and CIC-1401, Bordeaux School of Public Health; University of Bordeaux (C.D., L.R., R.T., M.B., H.A., J.-F.D., P.M., P.D., F.D., F.B., G.C.); and Public Health Department (C.D., L.R., R.T., M.B., F.D., G.C.), Internal Medicine and Infectious Disease Department (F.-A.D., P.M., P.D., F.B.), Neurology Department (J.-F.D.), and Infectious and Tropical Diseases Federation (D.N.), Bordeaux Hospital, France.
authors.forename: Fabrice
authors.initials: F
authors.lastname: Bonnet
authors.affiliation: From INSERM (C.D., L.R., R.T., M.B., H.A., J.-F.D., P.M., P.D., F.D., F.B., G.C.), Centre INSERM U897 and CIC-1401, Bordeaux School of Public Health; University of Bordeaux (C.D., L.R., R.T., M.B., H.A., J.-F.D., P.M., P.D., F.D., F.B., G.C.); and Public Health Department (C.D., L.R., R.T., M.B., F.D., G.C.), Internal Medicine and Infectious Disease Department (F.-A.D., P.M., P.D., F.B.), Neurology Department (J.-F.D.), and Infectious and Tropical Diseases Federation (D.N.), Bordeaux Hospital, France.
authors.forename: Geneviève
authors.initials: G
authors.lastname: Chêne
mesh_terms: D000328:Adult; D003072:Cognition Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D005602:France / Q000453:epidemiology; D015658:HIV Infections / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D015497:HIV-1; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies