Although older adults with HIV are at high risk for mild neurocognitive
disorders, a subset experience successful cognitive aging (SCA). HIV is associated
with an increased risk of vascular depression (VasDep), which can affect cognitive
and daily functioning. The current study examined whether VasDep impedes SCA among
older adults with HIV. 136 persons with HIV aged 50 years and older were classified
as either SCA+ (n = 37) or
SCA- (n = 99) based on a battery of
demographically adjusted neurocognitive tests and self-reported cognitive symptoms.
Participants were also stratified on the presence of vascular disease (e.g.,
hypertension) and current depression as determined by the Composite International
Diagnostic Interview and the Depression/Dejection scale of the Profile of Mood
States. A Cochran-Armitage test revealed a significant additive effect of vascular
disease and depression on SCA in this sample of older adults with HIV (z = 4.13, p <.0001). Individuals with VasDep had the lowest
frequency of SCA+ (0%), which differed significantly from the group
with only vascular disease (30%, OR = 0.04,
CI = 0.002,0.68)) and the group with neither vascular disease nor
depression (47% OR = 0.02, CI = 0.33,0.001).
Findings were not confounded by demographics, HIV disease severity, or other
psychiatric and medical factors (ps > 0.05). These data suggest that presence of
VasDep may be a barrier to SCA in older adults with HIV disease. Prospective,
longitudinal studies with neuroimaging-based operationalizations of VasDep are
needed to further clarify this risk factor’s role in the maintenance of
cognitive and brain health in persons with HIV disease.