Research Square · Mar 14, 2022
Midlife Body Mass Index, Central Adiposity and Neuropsychological Performance Over 10 Years in Women with and Without HIV Infection
By Vásquez E, Kuniholm MH, Appleton AA et al.
Abstract Background and Objective Overweight and obesity influence cognitive health, and measured during midlife, may be associated with declining neuropsychological performance (NP) and late-onset dementia in older adults. Few studies have considered these associations in women living with HIV (WLWH). We examined associations cross-sectionally and up to 10 years longitudinally between body mass index (BMI) and waist circumference (WC) and NP in middle-aged WLWH and women without HIV (HIV-).Methods.BMI and WC were measured in 432 virologically-suppressed WLWH and 367 HIV- women, >40 years, who participated in the Women’s Interagency HIV Study (WIHS) and with NP assessments every two years from 2009-2019. Demographically-adjusted T-scores were calculated for six NP domains: learning, memory, executive function, processing speed, attention and working memory, and motor function. Multivariable linear regression models stratified by HIV serostatus were used to examine cross-sectional associations of BMI and WC with each NP domain; repeated measures analyses assessed baseline BMI and WC in association with longitudinal change in NP. Results were outputted as beta-coefficients (b) and 95% Confidence Intervals (95%CI). Covariates included sociodemographic, behavioral, and HIV-related characteristics.ResultsAt baseline, obese WLWH (BMI>30.0 kg/m2) had poorer executive function (β=-2.27, 95%CI [-4.46, -0.07], p=0.043) compared to normal (BMI 18.5–24.9 kg/m2). Longitudinally over ~8 years follow-up, obese versus overweight WLWH improved on learning (β=1.88, 95%CI [0.24, 3.51], p=0.025).Among HIV- women, an overweight versus normal BMI was associated with declining memory (β=-3.13, 95%CI [-5.75, -0.51], p=0.019); however, obese versus overweight HIV- women improved on memory (β=2.47, 95%CI [0.47, 4.46], p=0.015). Among HIV- women, increasing WC was associated with decreasing executive (β=-0.07, 95%CI [-0.11, -0.02], p=0.058), processing speed (β=-0.05, 95%CI [-0.10, -0.01], p=0.044), and motor (β=-0.05, 95%CI [-0.10, -0.01], p=0.033) performance during follow-up.ConclusionsCross-sectional and longitudinal associations of BMI and central adiposity and NP were mixed among WLWH and HIV- women during midlife. However, HIV- women may experience greater NP decline in association with higher adiposity compared to WLWH.