title: Neurocognitive deficits increase risk of poor retention in care among older adults with newly diagnosed HIV infection.
abstract: OBJECTIVE
  To evaluate the role of neurocognitive impairment on retention in care across the lifespan in antiretroviral-naïve persons newly diagnosed with HIV.
  
  
  METHODS
  A prospective observational study of 138 antiretroviral-naive newly diagnosed HIV-positive participants who presented to an urban clinic between August 2010 and April 2013.
  
  
  METHODS
  All participants underwent a baseline evaluation that included a neuromedical examination and brief neuropsychological test battery. Retention in care was operationalized as attending at least two visits separated by more than 90 days during the 12-month follow-up period.
  
  
  RESULTS
  Fifty-five per cent of participants were retained in care over the study observation period. In a logistic regression controlling for ethnicity, there was a significant interaction between age and neurocognitive impairment in predicting retention in care (P = 0.009). Planned post-hoc analyses showed that neurocognitive impairment was associated with a significantly lower likelihood of retention in care among participants aged 50 years and older (P = .007), but not among younger participants (P > 0.05).
  
  
  CONCLUSIONS
  Extending prior research on antiretroviral adherence and medication management, findings from this study indicate that neurocognitive impairment may be an especially salient risk factor for poor retention in care among older adults with newly diagnosed HIV infection.
authors.affiliation: aDepartment of Internal Medicine, University of Texas Health Science Center in Houston bDepartment of Neurology, Division of Neuropsychology, Baylor College of Medicine, Houston cDepartment of Internal Medicine, Baylor College of Medicine dDepartment of Psychology, University of Houston, Texas, USA.
authors.forename: Amy
authors.initials: A
authors.lastname: Jacks
authors.forename: D' Arcy
authors.initials: DA
authors.lastname: Wainwright
authors.forename: Lucrecia
authors.initials: L
authors.lastname: Salazar
authors.forename: Richard
authors.initials: R
authors.lastname: Grimes
authors.forename: Michele
authors.initials: M
authors.lastname: York
authors.forename: Adriana M
authors.initials: AM
authors.lastname: Strutt
authors.forename: Lokesh
authors.initials: L
authors.lastname: Shahani
authors.forename: Steven Paul
authors.initials: SP
authors.lastname: Woods
authors.forename: Rodrigo
authors.initials: R
authors.lastname: Hasbun
mesh_terms: D000368:Aged; D005260:Female; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D019965:Neurocognitive Disorders / Q000150:complications*; D011446:Prospective Studies; D018570:Risk Assessment