Does Alcohol Use Increase Cognitive Impairment in HIV-Positive Individuals?
Cognitive neuropsychological and decision-making tests were done using the Cogstate battery and Iowa Gambling Task.
HIV-positive individuals with higher levels of recent alcohol consumption performed worse on several neurocognitive tests compared with a normative sample, but alcohol was not determined to be a primary factor on the test results, according to a recent study published Addictive Disorders & Their Treatment.
Changes in neurocognitive function are associated with HIV-positive individuals, but patterns of change vary across this population and may be mediated by other factors, including heavy drinking. Together, heavy drinking and neurocognitive change are common debilitating factors among seropositive individuals. In this study, the extent to which level of alcohol consumption is associated with cognitive function was explored.
HIV-positive individuals age 18 to 70 years undergoing highly active antiretroviral therapy, with a verbal IQ score ≥80, and who reported consuming alcohol in the last 90 days were included. Participants underwent initial assessments of reading ability and general intellectual function as well as interviews for psychiatric and drug use disorder, alcohol use disorder, recent alcohol and cannabis use, and adherence with highly active antiretroviral therapy, and filled out a public health questionnaire. Cognitive neuropsychological and decision-making tests were done using the Cogstate battery and Iowa Gambling Task, respectively.
Tests scores for psychomotor speed were >1 standard deviation away from the mean (mean=1.16; standard deviation=1.07). Remaining tests scores were all within normal limits, but overall performance was lower than expected. Associations between drinking and performance were not significant in multivariable tests. Individuals diagnosed with alcohol use disorder did perform significantly worse on attention tasks (P =.01) after adjustment for covariates. Cannabis use and self-reported drinking was significantly associated with decreased performance in the visual memory model after adjustments for age, race, and public health questionnaire-9 results.
Further research is required to understand the relationships between HIV, drinking, and premorbid or demographic factors. The lack of associations in the multivariate model may be the result of small sample sizes. Future studies will need to be, “large enough to provide adequate statistical power, and longitudinal designs should be tailored to allow a consideration of each factor's unique contribution” to changes in cognitive function.
Douglas-Newman KR, Smith RV, Spiers MV, Pond T, Kranzler HR. Effects of recent alcohol consumption level on neurocognitive performance in HIV+ individuals. Addict Disord Their Treat. 2017;16:95-107.