title: Aging, neurocognitive impairment and adherence to antiretroviral therapy in human immunodeficiency virus-infected individuals.
abstract: OBJECTIVE
  There is an increasing number of older patients with human immunodeficiency virus infection due to the success of antiretroviral therapy, the improved prognosis and life expectancy of patients, and the higher number of new infections among older individuals. The main objective of the present study was to compare the characteristics of older human immunodeficiency virus patients with those of younger patients.
  
  
  METHODS
  We conducted a cross-sectional study with human immunodeficiency virus-infected patients who were treated at the Specialized Care Service (Serviço de Assistência Especializada) for human immunodeficiency virus/AIDS in the city of Pelotas, South Brazil. Sociodemographic information as well as data on human immunodeficiency virus infection and treatment were collected. All participants underwent psychiatric and neurocognitive assessments, and their adherence to antiretroviral therapy was evaluated.
  
  
  RESULTS
  A total of 392 patients participated in the study, with 114 patients aged 50 years and older. The characteristics showing significant differences between older and younger human immunodeficiency virus-infected patients included race/ethnicity, comorbidities, duration and adherence to antiretroviral therapy, currently undetectable viral load, and cognitive impairment. Compared to younger patients, older patients were at higher risk of exhibiting cognitive impairment [OR 2.28 (95% CI: 1.35-3.82, p=0.002)] and of having increased adherence to antiretroviral therapy [OR 3.11 (95% CI: 1.67-5.79, p<0.001)].
  
  
  CONCLUSIONS
  The prevalence of neurocognitive impairment remained high in human immunodeficiency virus-infected patients despite antiretroviral therapy. In the present study, the prevalence of this type of impairment was significantly higher in patients aged ≥50 years, most likely due to aging, human immunodeficiency virus infection, and a possible synergistic effect between these factors. Despite this higher prevalence, older patients exhibited higher rates of adherence to antiretroviral therapy and of undetectable human immunodeficiency virus viral load.
authors: Universidade Federal de Pelotas, Faculdade de Medicina, Serviço de Asssitência Especializada em HIV AIDS, Pelotas, RS, Brazil; Universidade Católica de Pelotas, Programa de Pós-Graduação em Saúde e Comportamento, Pelotas, RS, Brazil. Electronic address: cezarart@terra.com.br.
authors: Cezar Arthur Tavares
authors: CA
authors: Pinheiro
authors: Universidade Católica de Pelotas, Programa de Pós-Graduação em Saúde e Comportamento, Pelotas, RS, Brazil.
authors: Luciano Dias de
authors: LD
authors: Mattos Souza
authors: Universidade Católica de Pelotas, Programa de Pós-Graduação em Saúde e Comportamento, Pelotas, RS, Brazil.
authors: Janaína Vieira Dos Santos
authors: JV
authors: Motta
authors: Universidade Católica de Pelotas, Programa de Pós-Graduação em Saúde e Comportamento, Pelotas, RS, Brazil.
authors: Evelin Franco
authors: EF
authors: Kelbert
authors: Universidade Católica de Pelotas, Programa de Pós-Graduação em Saúde e Comportamento, Pelotas, RS, Brazil.
authors: Clarissa de Souza Ribeiro
authors: CS
authors: Martins
authors: Universidade Católica de Pelotas, Programa de Pós-Graduação em Saúde e Comportamento, Pelotas, RS, Brazil.
authors: Marília Silva de
authors: MS
authors: Souza
authors: Universidade Católica de Pelotas, Programa de Pós-Graduação em Saúde e Comportamento, Pelotas, RS, Brazil.
authors: Karen Amaral Tavares
authors: KA
authors: Pinheiro
authors: Universidade Católica de Pelotas, Programa de Pós-Graduação em Saúde e Comportamento, Pelotas, RS, Brazil.
authors: Fábio Monteiro da Cunha
authors: FM
authors: Coelho
authors: Universidade Católica de Pelotas, Programa de Pós-Graduação em Saúde e Comportamento, Pelotas, RS, Brazil.
authors: Ricardo Tavares
authors: RT
authors: Pinheiro
mesh_terms: D015526:AIDS Dementia Complex / Q000188:drug therapy* / Q000503:physiopathology*; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000502:physiology*; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D023241:Antiretroviral Therapy, Highly Active; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D012959:Socioeconomic Factors; D019562:Viral Load
chemical_list: D019380:Anti-HIV Agents
keywords: Adherence; Aging; HIV; Neurocognitive impairment