Physical exercise is associated with less neurocognitive impairment among HIV-infected adults

Catherine A Dufour, Maria J Marquine, Pariya L Fazeli, Brook L Henry, Ronald J Ellis, Igor Grant, David J Moore, HNRP Group, Robert K Heaton, Igor Grant, J Hampton Atkinson, Ronald J Ellis, Scott Letendre, Thomas D Marcotte, Jennifer Marquie-Beck, Melanie Sherman, Ronald J Ellis, Scott Letendre, J Allen McCutchan, Brookie Best, Rachel Schrier, Terry Alexander, Debra Rosario, Robert K Heaton, J Hampton Atkinson, Steven Paul Woods, Thomas D Marcotte, Mariana Cherner, David J Moore, Matthew Dawson, Christine Fennema-Notestine, Terry Jernigan, Monte S Buchsbaum, John Hesselink, Sarah L Archibald, Gregory Brown, Richard Buxton, Anders Dale, Thomas Liu, Eliezer Masliah, Cristian Achim, Ian Everall, David M Smith, Douglas Richman, J Allen McCutchan, Mariana Cherner, Cristian Achim, Stuart Lipton, J Hampton Atkinson, Jennifer Marquie-Beck, Anthony C Gamst, Clint Cushman, Ian Abramson, Florin Vaida, Reena Deutsch, Anya Umlauf, Christi Kao, Catherine A Dufour, Maria J Marquine, Pariya L Fazeli, Brook L Henry, Ronald J Ellis, Igor Grant, David J Moore, HNRP Group, Robert K Heaton, Igor Grant, J Hampton Atkinson, Ronald J Ellis, Scott Letendre, Thomas D Marcotte, Jennifer Marquie-Beck, Melanie Sherman, Ronald J Ellis, Scott Letendre, J Allen McCutchan, Brookie Best, Rachel Schrier, Terry Alexander, Debra Rosario, Robert K Heaton, J Hampton Atkinson, Steven Paul Woods, Thomas D Marcotte, Mariana Cherner, David J Moore, Matthew Dawson, Christine Fennema-Notestine, Terry Jernigan, Monte S Buchsbaum, John Hesselink, Sarah L Archibald, Gregory Brown, Richard Buxton, Anders Dale, Thomas Liu, Eliezer Masliah, Cristian Achim, Ian Everall, David M Smith, Douglas Richman, J Allen McCutchan, Mariana Cherner, Cristian Achim, Stuart Lipton, J Hampton Atkinson, Jennifer Marquie-Beck, Anthony C Gamst, Clint Cushman, Ian Abramson, Florin Vaida, Reena Deutsch, Anya Umlauf, Christi Kao

Abstract

Neurocognitive impairment (NCI) remains prevalent in HIV infection. Randomized trials have shown that physical exercise improves NCI in non-HIV-infected adults, but data on HIV-infected populations are limited. Community-dwelling HIV-infected participants (n = 335) completed a comprehensive neurocognitive battery that was utilized to define both global and domain-specific NCI. Participants were divided into "exercise" (n = 83) and "no exercise" (n = 252) groups based on whether they self-reported engaging in any activity that increased heart rate in the last 72 h or not. We also measured and evaluated a series of potential confounding factors, including demographics, HIV disease characteristics, substance use and psychiatric comorbidities, and physical functioning. Lower rates of global NCI were observed among the exercise group (15.7 %) as compared to those in the no exercise group (31.0 %; p < 0.01). A multivariable logistic regression controlling for potential confounds (i.e., education, AIDS status, current CD4+ lymphocyte count, self-reported physical function, current depression) showed that being in the exercise group remained significantly associated with lower global NCI (odds ratio = 2.63, p < 0.05). Similar models of domain-specific NCI showed that exercise was associated with reduced impairment in working memory (p < 0.05) and speed of information processing (p < 0.05). The present findings suggest that HIV-infected adults who exercise are approximately half as likely to show NCI as compared to those who do not. Future longitudinal studies might be best suited to address causality, and intervention trials in HIV-infected individuals will determine whether exercise can prevent or ameliorate NCI in this population.

Figures

Fig. 1
Fig. 1
HIV-infected persons who have not exercised in last 72 hours have double the neurocognitive impairment rate of those who have exercised. Note: Statistical significance (*p<0.05) derived from multivariable logistic regressions modeling impairment in each domain by group and adjusting for potential confounds
Fig 2
Fig 2
Working memory and speed of information processing are significantly impaired in the No Exercise group as compared to the Exercise group. Note: Statistical significance (*p<0.05) derived from multivariable logistic regressions modeling impairment in each domain by group and adjusting for potential confounds

Source: PubMed

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