@article{ref1,
title="Impaired cognition predicts falls among women with and without HIV infection",
journal="Journal of Acquired Immune Deficiency Syndromes",
year="2020",
author="Sharma, Anjali and Vance, David E. and Hoover, Donald R. and Shi, Qiuhu and Yin, Michael T. and Holman, Susan and Plankey, Michael W. and Tien, Phyllis C. and Weber, Kathleen M. and Floris-Moore, Michelle and Bolivar, Hector H. and Golub, Elizabeth T. and McDonnell Holstad, Marcia and Rubin, Leah H.",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="OBJECTIVE: To determine if domain-specific neurocognitive (NC) impairments predict falls in HIV+ compared to HIV- women. <br><br>DESIGN: Cross-sectional data analysis from 825 HIV+ and 392 HIV- women in the Women's Interagency HIV Study (WIHS) with NC testing within two years prior to falls surveys. <br><br>METHODS: NC impairment (T score <40) was assessed in seven domains: executive function, psychomotor speed, attention, learning, memory, fluency, and fine motor function. For domains associated with any fall within 6 months in simple logistic regression (p<.05), hierarchical regression models evaluated associations between NC impairment and odds of falling, adjusting for: (1) study site and HIV, (2) demographics, (3) comorbid conditions, (4) substance use/CNS active medications, and HIV-specific factors. <br><br>RESULTS: Median age was higher in HIV+ than HIV- women (51yrs vs. 48yrs); prevalence of falls was similar (19% HIV+, 16% HIV-). Overall, executive function (OR [odds ratio]=1.82, 95%CI [confidence interval] 1.21-2.74; P=0.004), psychomotor speed (OR=1.59, 95%CI 1.05-2.42, P=0.03), and fine motor (OR 1.70, 95%CI 1.11-2.61, P=0.02) impairments were associated with greater odds of falls in fully adjusted models. In fully adjusted models, associations of executive function, psychomotor speed, and fine motor were non-significant among HIV+ women; conversely, among HIV- women, associations with impaired executive and fine motor functions were strengthened, and remained significant. <br><br>CONCLUSIONS: Cognitive impairment was associated with falls among middle-aged HIV- but not HIV+ women. Additional studies should elucidate mechanisms by which domain-specific NC impairment impacts fall risk among older HIV+ and HIV- women, and how different factors modify relationships between cognition and falls.<p /> <p>Language: en</p>",
language="en",
issn="1525-4135",
doi="10.1097/QAI.0000000000002262",
url="http://dx.doi.org/10.1097/QAI.0000000000002262"
}