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