Psychiatric and neurocognitive disorders among HIV-positive and negative veterans in care: Veterans Aging Cohort Five-Site Study

AIDS. 2004 Jan 1;18 Suppl 1:S49-59.


Background: The risk for psychiatric and neurocognitive disorders among middle-aged and older individuals with HIV infection has not been well characterized.

Methods: The Veterans Aging Cohort 5-Site Study enrolled 1803 patients (1047 HIV-positive) from VA infectious disease and general medicine clinics from September 2001 to June 2002. A convenience subset of 10 patients from each site (n = 50) was consented for formal neurocognitive and psychiatric (NCP) testing. Data from this subset were linked to the larger sample.

Results: Kappa scores for agreement beyond chance were fair for available measures when compared with formal NCP testing. Using available measures, depressive symptoms (PHQ-9 and provider reported), alcohol abuse or dependence (ICD-9 codes), and drug abuse or dependence (DAST-10) decreased with age in HIV-negative subjects (P trend <0.05) but did not among HIV-positive subjects (P > 0.05). HIV-positive subjects demonstrated higher prevalence of these conditions with increasing age when compared to HIV-negative subjects. Patient report of memory problems increased with age among both groups after excluding those reporting symptoms of depression (PHQ-9e > or = 10).

Conclusion: Available measures were no substitute for formal NCP testing. Older HIV-positive veterans demonstrate greater prevalence of depressive symptoms, alcohol abuse or dependence, and drug abuse or dependence than age-matched, HIV-negative veterans. Both groups reported increased memory problems with advancing age. This preliminary work suggests a substantial prevalence of psychiatric and neurocognitive problems among middle-aged and older HIV-infected individuals.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Age Distribution
  • Aged
  • Aged, 80 and over
  • Aging / physiology
  • Alcohol Drinking
  • Cognition Disorders / complications
  • Cognition Disorders / epidemiology
  • Cohort Studies
  • Depressive Disorder / complications
  • Depressive Disorder / epidemiology
  • Female
  • HIV Seronegativity
  • HIV Seropositivity / complications*
  • HIV Seropositivity / epidemiology
  • HIV Seropositivity / psychology
  • Humans
  • Male
  • Memory Disorders / complications
  • Memory Disorders / epidemiology
  • Mental Disorders / complications*
  • Mental Disorders / epidemiology
  • Middle Aged
  • Neuropsychological Tests
  • Prevalence
  • Substance-Related Disorders / complications
  • Substance-Related Disorders / epidemiology