Physical exercise is associated with less neurocognitive impairment among HIV-infected adults

Abstract

Neurocognitive impairment (NCI) remains prevalent in HIV-infection. Randomized trials have shown that physical exercise improves NCI in non HIV-infected adults, but data on HIV-infected populations is limited. Community-dwelling HIV-infected participants (n=335) completed a comprehensive neurocognitive battery that was utilized to define both global and domain-specific NCI. Participants were divided into “Exercise” (n=83) and “No Exercise” (n=252) groups based on whether they self-reported engaging in any activity that increased heart rate in the last 72 hours or not. We also measured and evaluated a series of potential confounding factors, including demographics, HIV-disease characteristics, substance use and psychiatric comorbidities, and physical functioning. Lower rates of global NCI were observed among the Exercise group (15.7%) as compared to those in the No Exercise group (31.0%; p<.01). A multivariable logistic regression controlling for potential confounds (i.e., education, AIDS status, current CD4+ lymphocyte count, self-reported physical function, current depression) showed that being in the Exercise group remained significantly associated with lower global NCI (OR=2.63, p<.05). Similar models of domain-specific NCI showed that Exercise was associated with reduced impairment in working memory (p<.05) and speed of information processing (p<.05). The present findings suggest that HIV-infected adults who exercise are approximately half as likely to show NCI as compared to those who do not. Future longitudinal studies might be best suited to address causality and intervention trials in HIV-infected individuals will determine whether exercise can prevent or ameliorate NCI in this population.

A Longitudinal Analysis of the Impact of Physical Activity on Neurocognitive Functioning Among HIV-Infected Adults

“…This finding is consistent with previous research documenting that inconsistent or no PA is associated with concurrent risk for NCI in HIV-infected adults [36,37]. As would be expected, HIV-infected persons had worse neurocognitive function overall.…”

“…The relatively limited research on PA and cognition among those living with HIV is consistent with what has been shown among HIV-uninfected adults; higher levels of PA are associated with decreased concurrent risk for NCI [36][37][38]. Moreover, work by our group among older adults living with HIV has shown that active lifestyles (including PA) are associated with better cognition and that PA is associated with better cognition and everyday functioning among older adults living with HIV [39,40].…”

“…Due to the skewed distribution of the time spent in PA variable, for each study visit we dichotomized this variable into whether a participant reported any PA or not. This is consistent with the methodology previously used by our group using this measure [36]. We then divided participants into three groups based on their responses across study visits.…”

“…This is consistent with the annual visit structure for most of the studies from which these data were gathered. Median follow-up time over the full study period for the overall sample was 35 [24,36] months. A participant's earliest visit with both primary data points of interest was considered the baseline assessment for this study and was used to compare demographic variables between groups.…”

Aspects of Cognition/Health Failure by HIV-infected Individuals: Amelioration through Exercise

“…Certainly, exercise interventions for Nigerian HIV-patients (18 years and above) improved markedly both pulmonary functions and alleviated respiratory and depressive symptoms [35]. Physical activity engagement and employment are linked to greater performance in neurocognitive tasks [36][37][38]. Cross-sectional studies have indicated that activity and active engagement in daily activities bolsters neurocognitive functioning [39].…”