Poor subjective sleep predicts compromised quality of life but not cognitive impairment in abstinent individuals with Alcohol Use Disorder

Piekarski, David J.; Sullivan, Edith V.; Pfefferbaum, Adolf; Zahr, Natalie M.

doi:10.1016/j.alcohol.2022.07.001

Cited by 8 publications

(6 citation statements)

References 69 publications

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“…Instead, higher global PSQI scores correlated with higher scores on the BDI, a questionnaire that evaluates depressive symptoms. In several populations, including nurses [ 101 ], those with chronic kidney disease [ 102 ], alcohol use disorder [ 98 ], and multiple sclerosis [ 103 ], correlations between PSQI and BDI scores have been reported suggesting that poor sleep can contribute to depressive symptoms. Other reports citing poor PSQI sleep correlates with CD4 count [ 45 – 49 ] or psychiatric diagnoses [e.g., 31 , 38 , 52 , 53 ] were not replicated.…”

Section: Discussionmentioning

confidence: 99%

Poor subjective sleep reported by people living with HIV is associated with impaired working memory

Zahr

Sullivan

Pfefferbaum

2023

NeuroImmune Pharmacology and Therapeutics

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Poor sleep can undermine health and may be especially disruptive to those with chronic conditions including HIV infection. Here, clinically well-described people living with HIV [PLWH] (74 men, 35 women) and healthy control (38 men, 35 women) participants were administered the Pittsburgh Sleep Quality Index (PSQI), a validated measure of subjective sleep with a global score ≥5 able to distinguish good from poor sleepers. In addition, participants completed a battery of neuropsychological tests. PLWH (6.8 ± 3.7) had higher global PSQI scores than healthy controls (4.1 ± 2.8): 39.7 % of uninfected controls and 68.8 % of PLWH had a PSQI≥5 indicative of poor sleep. There were no relations between the global PSQI score and any evaluated variables among uninfected individuals or with demographic or HIV-related variables in PLWH. Instead, a higher global PSQI score among PLWH was associated with worse “Quality of Life” scores [Global Assessment of Functioning (GAF, p=0.0007), Medical Outcomes Study survey (21-item short form, SF-21, p<0.0001), and Activities of Daily Living-Instrumental (ADL-I, p=0.0041)] and higher Beck Depression Index (BDI, p<0.0001) depressive symptoms. Further, in PLWH, higher global PSQI scores were associated with poor performance on a working memory task, the digit backward span (p=0.0036). In PLWH, the 5 variables together explained 32.3 % of the global PSQI score variance; only 3 variables – the SF-21, BDI, and digit backward scores – explained 30.6 % of the variance. To the extent that poor subjective sleep contributes to impaired working memory in HIV, we speculate that this impairment may be ameliorated by improved sleep health.

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Section: Discussionmentioning

confidence: 99%

Poor subjective sleep reported by people living with HIV is associated with impaired working memory

Zahr

Sullivan

Pfefferbaum

2023

NeuroImmune Pharmacology and Therapeutics

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“…Cognitive composite scores matched to date of blood draw for each participant were extracted from an in-house laboratory release as described [ 67 , 98 ]. Briefly, composites cognitive scores were created by averaging age-, education-, and sex-corrected Z-scores on performance on neuropsychological tests.…”

Section: Methodsmentioning

confidence: 99%

Serum albumin and white matter hyperintensities

Zahr,

Pfefferbaum

2024

Preprint

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Urine albumin, high in kidney disease, predicts cardiovascular incidents and CNS white matter hyperintensity (WMH) burdens. Serum albumin – a more general biomarker which can be low in several disorders – including kidney and liver disease, malnutrition, and inflammation – also predicts cardiovascular events and is associated with cognitive impairment in several clinical populations; relations between serum albumin and WMH prevalence, however, have rarely been evaluated. In a sample of 160 individuals with alcohol use disorder (AUD), 142 infected with HIV, and 102 healthy controls, the hypothesis was tested that lower serum albumin levels would predict larger WMH volumes and worse cognitive performance irrespective of diagnosis. After considering traditional cardiovascular risk factors (e.g., age, sex, body mass index (BMI), nicotine use, hypertension, diabetes) and study-relevant variables (i.e., primary diagnoses, race, socioeconomic status, hepatitis C virus status), serum albumin survived false discovery rate (FDR)-correction in contributing variance to larger periventricular but not deep WMH volumes. This relationship was salient in the AUD and HIV groups, but not the control group. In secondary analyses, serum albumin and periventricular WMH along with age, sex, diagnoses, BMI, and hypertension were considered for hierarchical contribution to variance in performance in 4 cognitive domains. Albumin survived FDR-correction for significantly contributing to visual and verbal learning and memory performance after accounting for diagnosis. Relations between albumin and markers of liver integrity [e.g., aspartate transaminase (AST)] and blood status (e.g., hemoglobin, red blood cell count, red cell distribution width) suggest that in this sample, albumin reflects both liver dysfunction and hematological abnormalities. The current results suggest that albumin, a simple serum biomarker available in most clinical settings, can predict variance in periventricular WMH volumes and performance in visual and verbal learning and memory cognitive domains. Whether serum albumin contributes mechanistically to periventricular WMH prevalence will require additional investigation.

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“…Cognitive composite scores matched to date of blood draw for each participant were extracted from an in-house laboratory release as described [ 51 , 90 ]. Briefly, composites cognitive scores were created by averaging age-, education-, and sex-corrected Z-scores on performance on neuropsychological tests.…”

Section: Methodsmentioning

confidence: 99%

Serum albumin and white matter hyperintensities

Zahr,

Pfefferbaum

2024

Transl Psychiatry

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People living with HIV and those diagnosed with alcohol use disorders (AUD) relative to healthy individuals commonly have low levels of serum albumin, substantiated as an independent predictor of cardiovascular events. White matter hyperintensities (WMH)—a neuroimaging feature of cerebral small vessel disease—are also related to cardiovascular disease. Despite consensus regarding associations between high levels of urine albumin and WMH prevalence, and low serum albumin levels and impaired cognitive functioning, relations between serum albumin and WMH burdens have rarely been evaluated. Here, a sample including 160 individuals with AUD, 142 living with HIV, and 102 healthy controls was used to test the hypothesis that serum albumin would be inversely related to WMH volumes and directly related to cognitive performance in the two diagnostic groups. Although serum albumin and periventricular WMH volumes showed an inverse relationship in both AUD and HIV groups, this relationship persisted only in the HIV group after consideration of traditional cardiovascular (i.e., age, sex, body mass index (BMI), nicotine use, hypertension, diabetes), study-relevant (i.e., race, socioeconomic status, hepatitis C virus status), and disease-specific (i.e., CD4 nadir, HIV viral load, HIV duration) factors. Further, serum albumin contributed more significantly than periventricular WMH volume to variance in performance on a verbal learning and memory composite score in the HIV group only. Relations in both HIV and AUD groups between albumin and hematological red blood cell markers (e.g., hemoglobin, hematocrit) suggest that in this sample, serum albumin reflects hematological abnormalities. Albumin, a simple serum biomarker available in most clinical settings, may therefore help identify periventricular WMH burden and performance levels in specific cognitive domains in people living with HIV. Whether serum albumin contributes mechanistically to periventricular WMH in HIV will require additional investigation.

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Poor subjective sleep predicts compromised quality of life but not cognitive impairment in abstinent individuals with Alcohol Use Disorder

Cited by 8 publications

References 69 publications

Poor subjective sleep reported by people living with HIV is associated with impaired working memory

Poor subjective sleep reported by people living with HIV is associated with impaired working memory

Serum albumin and white matter hyperintensities

Serum albumin and white matter hyperintensities

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