Impact of HIV‑associated cognitive impairment on functional independence, frailty and quality of life in the modern era: a meta‑analysis

Loading...
Thumbnail Image

Authors

Nweke, Martins C.
Mshunqane, Nombeko
Govender, Nalini
Akinpelu, Aderonke
Ukwuoma, Maryjane

Journal Title

Journal ISSN

Volume Title

Publisher

Nature Research

Abstract

HIV-associated neurocognitive disorder (HAND) is an important sequela of HIV infection. Combined antiretroviral therapy (cART) has improved the health outcomes of many people living with HIV but has given rise to a less severe but limiting form of HAND. The study aimed to evaluate the impact of HAND on medication adherence, activities of daily living (ADL), quality of life and frailty. This systematic review adheres to the guidelines for Preferred Reporting Items for Systematic Reviews and Meta-Analyses. We searched MEDLINE, PubMed, CINAHL, Academic Search Complete, and PsycINFO online databases. Studies were included if they examined the relationship between HAND and medication adherence, ADL, quality of life and frailty, and were conducted between 1997 and 2021. We used a random-efects meta-analysis model to assess the impact of HAND on outcome variables. Forty papers, totaling 11,540 participants, were included in the narrative and quantitative syntheses. Cognitive impairment was associated with poorer medication adherence (r= 0.601, CI 0.338 to 0.776, p = 0.001, I 2 = 94.66). Cognitive impairment did not infuence ADL (r = 0.167, CI-0.215 to 0.505, p = 0.393) and quality of life (r = 0.244, CI 0.117 to 0.548, p = 0.182). In the cART era, HAND appears to be associated with adherence to medication, which may infuence future health outcomes. In PLWHIV who are adherent to cART, cognitive impairment does not appear to interfere with ADL and quality of life.

Description

Keywords

Cognitive impairment, Functional independence, Human immunodeficiency virus (HIV), HIV-associated neurocognitive disorder (HAND), Combined antiretroviral therapy (cART), People living with HIV (PLHIV), Medication adherence, Activities of daily living (ADL), Quality of life (QoL), Frailty

Sustainable Development Goals

Citation

Nweke, M., Mshunqane, N., Govender, N., Akinpelu, A.O. & Ukwuoma, M. Impact of HIV-associated cognitive impairment on functional independence, frailty and quality of life in the modern era: a meta-analysis. Scientific Reports 2022 Apr 19;12(1):6470. doi: 10.1038/s41598-022-10474-8.