Geriatric Syndromes in Older Adults Living with HIV and Cognitive Impairment

J Am Geriatr Soc. 2019 Sep;67(9):1913-1916. doi: 10.1111/jgs.16034. Epub 2019 Jun 26.


Objectives: Nearly half of the population living with human immunodeficiency virus (HIV) in the United States is now older than 50 years with at least 6% over age 65. Between 35% and 50% live with mild to moderate cognitive impairment. Older persons living with HIV (PLWH) also have a substantial burden of HIV-associated non-acquired immunodeficiency syndrome medical conditions and are at risk for frailty, geriatric syndromes, and early mortality compared with HIV-uninfected peers. We sought to define the magnitude of geriatric conditions and multimorbidity in PLWH older than 60 years who are living with symptomatic cognitive impairment. In a subset of participants, we examined associations between these geriatric conditions.

Design: Retrospective cohort study.

Setting: HIV Elders Study at the University of California, San Francisco, Memory and Aging Center.

Participants: Participants were HIV infected, virally suppressed, 60 years or older, and clinically diagnosed with mild neurocognitive disorder (MND).

Measurements: We conducted standardized assessment of geriatric conditions and everyday function and investigated multimorbidity burden using the Veterans Aging Cohort Study (VACS) index.

Results: Among 141 older PLWH with MND, 58% report incontinence, 55% meet criteria for pre-frailty, and a substantial proportion report dependence with instrumental activities of daily living (52%) or activities of daily living (41%). The mean VACS index score is 33 (standard deviation = 14), suggesting a 13.8% 5-year all-cause mortality risk.

Conclusions: Older PLWH with symptomatic cognitive impairment carry a substantial burden of other geriatric conditions. Our work supports the need for comprehensive geriatric systems of care for cognitively impaired individuals aging with HIV. J Am Geriatr Soc 67:1913-1916, 2019.

Keywords: HIV; aging; cognition; frailty.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Aged
  • Aged, 80 and over
  • Cognitive Dysfunction / epidemiology*
  • Cognitive Dysfunction / virology
  • Female
  • Geriatric Assessment
  • HIV Infections / epidemiology*
  • HIV Infections / psychology
  • Humans
  • Male
  • Multiple Chronic Conditions / epidemiology*
  • Retrospective Studies
  • San Francisco / epidemiology
  • Syndrome
  • Veterans / statistics & numerical data*