The association between physical activity and cognition in men with and without HIV infection

Abstract

Objectives HIV-associated neurocognitive disorders are highly prevalent, and physical activity (PA) is a modifiable behaviour that may affect neurocognitive function. Our objective was to determine the association between PA and neurocognitive function and the effect of HIV on this association. Methods PA was assessed in the Multicenter AIDS Cohort Study with the International Physical Activity Questionnaire. A neuropsychological test battery assessed global impairment and domain-specific impairment (executive function, speed of processing, working memory, learning, memory, and motor function) every 2 years. Semiannually, the Symbol Digit Modalities Test and Trail Making Test Parts A and B were performed. Adjusted logistic regression models were used to assess the PA–neurocognitive function association. Using longitudinal data, we also assessed the PA category–decline of neurocognitive function association with multivariate simple regression. Results Of 601 men, 44% were HIV-infected. Low, moderate, and high PA was reported in 27%, 25%, and 48% of the HIV-infected men vs. 19%, 32% and 49% of the HIV-uninfected men, respectively. High PA was associated with lower odds of impairment of learning, memory, and motor function [odds ratio (OR) ranging from 0.52 to 0.57; P < 0.05 for all]. The high PA–global impairment association OR was 0.63 [95% confidence interval (CI) 0.39, 1.02]. Among HIV-infected men only, across multiple domains, the high PA–impairment association was even more pronounced (OR from 0.27 to 0.49). Baseline high/moderate PA was not associated with decline of any domain score over time. HIV infection was marginally associated with a higher speed of decline in motor function. Conclusions A protective effect of high PA on impairment in neurocognitive domains was observed cross-sectionally. Longitudinal PA measurements are needed to elucidate the PA–neurocognitive function relationship over time.

Aerobic Exercise in HIV-Associated Neurocognitive Disorders: Protocol for a Randomized Controlled Trial

“…Currently, few exercise interventions and treatment guidelines exist for rehabilitating HAND except for evidence-informed recommendations reported by O’Brien et al [ 40 ]. Although physical exercise may slow the decline in cognitive functioning among people living with HIV, research-generated evidence remains inconclusive due to heterogeneity in study designs and use of low-intensity exercises [ 32 , 41 , 42 ]. A recent systematic review revealed that the effect of structured exercise interventions on cognitive performance of individuals with HAND has not been investigated [ 43 ].…”

Behavioral and Physical Activity Interventions for HAND

“…Longitudinally, persons living with HIV who consistently engage in physical activity begin with, and maintain, significantly better neurocognitive function compared to persons living with HIV who do not engage in physical activity or do so inconsistently (Dufour et al 2018). In a longitudinal Multicenter AIDS Cohort Study, high engagement in physical activity was associated with lower odds of impairment in the domains of learning, memory, and motor function, and these effects were found to be more pronounced among the sample of men living with HIV compared to the pooled sample of men living with HIV and HIV-uninfected men (Monroe et al 2017). In a scoping review of the effect of physical activity on neurocognitive function among people living with HIV (Quigley et al 2018), noninterventional studies reported a positive association between physical activity engagement in neurocognitive function, whereas there was a dearth of positive outcomes of aerobic interventions on neurocognition.…”

Feasibility and Impact of a Yoga Intervention on Cognition, Physical Function, Physical Activity, and Affective Outcomes among People Living with HIV: A Randomized Controlled Pilot Trial

“…This finding is in keeping with those of McDermott et al, whose 16-week aerobic exercise intervention (n ¼ 11) did not have an effect on cognitive performance among PLWH. 63 Evidence from the cross-sectional literature has showed positive associations between physical activity and better cognitive function among PLWH, [64][65][66][67][68][69][70][71] but RCT evidence has yet to determine a causal relationship. There are a few potential reasons for the lack of effect of the intervention on cognitive performance in the present study.…”