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

dc.contributor.authorNweke, Martins C.
dc.contributor.authorMshunqane, Nombeko
dc.contributor.authorGovender, Nalini
dc.contributor.authorAkinpelu, Aderonke
dc.contributor.authorUkwuoma, Maryjane
dc.date.accessioned2022-11-02T13:17:08Z
dc.date.available2022-11-02T13:17:08Z
dc.date.issued2022-04-19
dc.description.abstractHIV-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.en_US
dc.description.departmentPhysiotherapyen_US
dc.description.sponsorshipThe National Student Financial Aid Scheme (NSFAS) via the University Pretoria Doctoral Research Bursary.en_US
dc.description.urihttps://www.nature.com/srepen_US
dc.identifier.citationNweke, 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.en_US
dc.identifier.issn2045-2322 (online)
dc.identifier.other10.1038/s41598-022-10474-8
dc.identifier.urihttps://repository.up.ac.za/handle/2263/88118
dc.language.isoenen_US
dc.publisherNature Researchen_US
dc.rights© The Author(s) 2021. Open Access. This article is licensed under a Creative Commons Attribution 4.0 International License.en_US
dc.subjectCognitive impairmenten_US
dc.subjectFunctional independenceen_US
dc.subjectHuman immunodeficiency virus (HIV)en_US
dc.subjectHIV-associated neurocognitive disorder (HAND)en_US
dc.subjectCombined antiretroviral therapy (cART)en_US
dc.subjectPeople living with HIV (PLHIV)en_US
dc.subjectMedication adherenceen_US
dc.subjectActivities of daily living (ADL)en_US
dc.subjectQuality of life (QoL)en_US
dc.subjectFrailtyen_US
dc.titleImpact of HIV‑associated cognitive impairment on functional independence, frailty and quality of life in the modern era: a meta‑analysisen_US
dc.typeArticleen_US

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