Moderate‐to‐severe cognitive impairment is associated with both recent and chronic alcohol misuse in people with HIV: The New Orleans alcohol use in HIV (NOAH) study

酒精使用障碍鉴定试验 蒙特利尔认知评估 神经认知 认知 医学 队列 酒精使用障碍 共病 认知功能衰退 精神科 心理学 认知障碍 痴呆 毒物控制 伤害预防 环境卫生 内科学 疾病 化学 生物化学
作者
Taylor Fitzpatrick‐Schmidt,Evrim Oral,David A. Welsh,Patricia E. Molina,Tekeda Ferguson,Scott Edwards
标识
DOI:10.1111/acer.15378
摘要

Abstract Background Human immunodeficiency virus (HIV) profoundly impacts the nervous system, leading to neurological deficits including HIV‐associated neurocognitive disorder (HAND). HAND represents the most common neurological comorbidity among people with HIV (PWH), and alcohol use may exacerbate cognitive deficits, especially in vulnerable populations. This study investigated relationships between alcohol use and cognition in an underserved cohort of PWH, on the hypothesis that alcohol misuse exacerbates cognitive deficits. Methods Data collected from participants ( n = 259; 66.7% male; mean age 52 ± 10 years) enrolled in the New Orleans Alcohol Use in HIV (NOAH) study were utilized for cross‐sectional analysis. Cognitive function was assessed using the Montreal Cognitive Assessment (MoCA), and alcohol use was comprehensively measured using four metrics: the Alcohol Use Disorders Identification Test (AUDIT), 30‐day timeline follow back (TLFB), lifetime drinking history, and phosphatidylethanol (PEth) levels. Results The average MoCA score among participants was 20.7 ± 4.5, with 86.5% demonstrating cognitive impairment (MoCA < 26). Individuals with MoCA scores below 18 (moderately or severely cognitively impaired) had a higher frequency of recent severe alcohol misuse and greater lifetime alcohol consumption. Participants at increased risk for AUD (AUDIT ≥ 16) also had worse global cognition and memory task performance than those with lower AUDIT scores; this was particularly true among those aged 50 and older. Analysis of the MoCA sub‐score data indicated that participants with increased AUD risk had impairments in the cognitive domains of language and memory. Conclusions Our findings demonstrate a high prevalence of cognitive impairment in the NOAH cohort and suggest that alcohol misuse contributes to global cognitive deficits in PWH, especially among individuals aged 50 and older. Further exploration of the impact of alcohol use on specific cognitive domains, including memory and language, should incorporate additional cognitive tasks. These findings highlight the importance of considering alcohol use and AUD risk as significant factors that may exacerbate cognitive deficits in vulnerable populations, including older PWH.

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