The Role of Depressive Symptoms and Physical Activity Levels in Mediating the Association Between HIV Status and Neurocognitive Functions Among Individuals Aged at Least 50 Years in China: Cross-sectional Study

Pei Qin; Jianmei He; Xue Yang; Siyu Chen; Xi Chen; Hui Jiang; Ada Wai Tung Fung; Zixin Wang; Joseph Tak Fai Lau

doi:10.2196/32968

The Role of Depressive Symptoms and Physical Activity Levels in Mediating the Association Between HIV Status and Neurocognitive Functions Among Individuals Aged at Least 50 Years in China: Cross-sectional Study

Pei Qin, Jianmei He, Xue Yang, Siyu Chen, Xi Chen, Hui Jiang, Ada Wai Tung Fung, Zixin Wang, Joseph Tak Fai Lau^*

^*Corresponding author for this work

Research output: Contribution to journal › Journal article › peer-review

2 Citations (Scopus)

Abstract

Background: Neurocognitive impairments are prevalent among older people in China. It is more problematic among older people living with HIV.

Objective: This study aims to compare neurocognitive performance between older people living with HIV and HIV-negative controls, and to explore whether the association between HIV status and neurocognitive performance was mediated by depressive symptoms and level of physical activity.

Methods: A cross-sectional study was conducted in Yongzhou, China. All people living with HIV aged ≥50 years listed in the registry were invited. Frequency matching was used to sample HIV-negative controls from the general population according to the distribution of age, sex, and years of formal education of older people living with HIV. A total of 315 older people living with HIV and 350 HIV-negative controls completed the face-to-face interview and comprehensive neuropsychological assessment of seven domains (learning, memory, working memory, verbal fluency, processing speed, executive function, and motor skills).

Results: As compared to HIV-negative controls, older people living with HIV performed worse in global score and all seven domains (P<.05). HIV infection was associated with higher depressive symptoms (P<.001) and lower level of physical activity (P<.001). Depressive symptoms and physical activity were negatively correlated (P<.001). Depressive symptoms and level of physical activity mediated the association between HIV status and global z-score and four domain z-scores of neurocognitive performance (learning, memory, verbal fluency, and processing speed).

Conclusions: Change in mental health and physical activity after HIV infection may partially explain why older people living with HIV are more susceptible to neurocognitive impairment. Promoting mental health and physical activity are potential entry points to slow down the progress of neurocognitive impairment among older people living with HIV.

Original language	English
Article number	e32968
Journal	JMIR Public Health and Surveillance
Volume	8
Issue number	8
DOIs	https://doi.org/10.2196/32968
Publication status	Published - 19 Aug 2022

Scopus Subject Areas

Public Health, Environmental and Occupational Health
Health Informatics

User-Defined Keywords

depression
depressive symptoms
HIV
HIV sero-status
level of physical activity
mediation effects
mental health
neurocognitive
neurocognitive performance
physical activity
public health

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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Qin, P., He, J., Yang, X., Chen, S., Chen, X., Jiang, H., Fung, A. W. T., Wang, Z., & Lau, J. T. F. (2022). The Role of Depressive Symptoms and Physical Activity Levels in Mediating the Association Between HIV Status and Neurocognitive Functions Among Individuals Aged at Least 50 Years in China: Cross-sectional Study. JMIR Public Health and Surveillance, 8(8), Article e32968. https://doi.org/10.2196/32968

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title = "The Role of Depressive Symptoms and Physical Activity Levels in Mediating the Association Between HIV Status and Neurocognitive Functions Among Individuals Aged at Least 50 Years in China: Cross-sectional Study",

abstract = "Background: Neurocognitive impairments are prevalent among older people in China. It is more problematic among older people living with HIV.Objective: This study aims to compare neurocognitive performance between older people living with HIV and HIV-negative controls, and to explore whether the association between HIV status and neurocognitive performance was mediated by depressive symptoms and level of physical activity.Methods: A cross-sectional study was conducted in Yongzhou, China. All people living with HIV aged ≥50 years listed in the registry were invited. Frequency matching was used to sample HIV-negative controls from the general population according to the distribution of age, sex, and years of formal education of older people living with HIV. A total of 315 older people living with HIV and 350 HIV-negative controls completed the face-to-face interview and comprehensive neuropsychological assessment of seven domains (learning, memory, working memory, verbal fluency, processing speed, executive function, and motor skills).Results: As compared to HIV-negative controls, older people living with HIV performed worse in global score and all seven domains (P<.05). HIV infection was associated with higher depressive symptoms (P<.001) and lower level of physical activity (P<.001). Depressive symptoms and physical activity were negatively correlated (P<.001). Depressive symptoms and level of physical activity mediated the association between HIV status and global z-score and four domain z-scores of neurocognitive performance (learning, memory, verbal fluency, and processing speed).Conclusions: Change in mental health and physical activity after HIV infection may partially explain why older people living with HIV are more susceptible to neurocognitive impairment. Promoting mental health and physical activity are potential entry points to slow down the progress of neurocognitive impairment among older people living with HIV.",

keywords = "depression, depressive symptoms, HIV, HIV sero-status, level of physical activity, mediation effects, mental health, neurocognitive, neurocognitive performance, physical activity, public health",

author = "Pei Qin and Jianmei He and Xue Yang and Siyu Chen and Xi Chen and Hui Jiang and Fung, {Ada Wai Tung} and Zixin Wang and Lau, {Joseph Tak Fai}",

note = "Funding Information: This study was supported by the Health and Family Planning Commission in the Hunan Province, China (C2016031). The funder had no role in the study design, data collection, analysis and interpretation, or manuscript preparation. Publisher Copyright: {\textcopyright} Pei Qin, Jianmei He, Xue Yang, Siyu Chen, Xi Chen, Hui Jiang, Ada Wai Tung Fung, Zixin Wang, Joseph Tak Fai Lau.",

year = "2022",

month = aug,

day = "19",

doi = "10.2196/32968",

language = "English",

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Qin, P, He, J, Yang, X, Chen, S, Chen, X, Jiang, H, Fung, AWT, Wang, Z & Lau, JTF 2022, 'The Role of Depressive Symptoms and Physical Activity Levels in Mediating the Association Between HIV Status and Neurocognitive Functions Among Individuals Aged at Least 50 Years in China: Cross-sectional Study', JMIR Public Health and Surveillance, vol. 8, no. 8, e32968. https://doi.org/10.2196/32968

The Role of Depressive Symptoms and Physical Activity Levels in Mediating the Association Between HIV Status and Neurocognitive Functions Among Individuals Aged at Least 50 Years in China: Cross-sectional Study. / Qin, Pei; He, Jianmei; Yang, Xue et al.
In: JMIR Public Health and Surveillance, Vol. 8, No. 8, e32968, 19.08.2022.

Research output: Contribution to journal › Journal article › peer-review

TY - JOUR

T1 - The Role of Depressive Symptoms and Physical Activity Levels in Mediating the Association Between HIV Status and Neurocognitive Functions Among Individuals Aged at Least 50 Years in China: Cross-sectional Study

AU - Qin, Pei

AU - He, Jianmei

AU - Yang, Xue

AU - Chen, Siyu

AU - Chen, Xi

AU - Jiang, Hui

AU - Fung, Ada Wai Tung

AU - Wang, Zixin

AU - Lau, Joseph Tak Fai

N1 - Funding Information: This study was supported by the Health and Family Planning Commission in the Hunan Province, China (C2016031). The funder had no role in the study design, data collection, analysis and interpretation, or manuscript preparation. Publisher Copyright: © Pei Qin, Jianmei He, Xue Yang, Siyu Chen, Xi Chen, Hui Jiang, Ada Wai Tung Fung, Zixin Wang, Joseph Tak Fai Lau.

PY - 2022/8/19

Y1 - 2022/8/19

N2 - Background: Neurocognitive impairments are prevalent among older people in China. It is more problematic among older people living with HIV.Objective: This study aims to compare neurocognitive performance between older people living with HIV and HIV-negative controls, and to explore whether the association between HIV status and neurocognitive performance was mediated by depressive symptoms and level of physical activity.Methods: A cross-sectional study was conducted in Yongzhou, China. All people living with HIV aged ≥50 years listed in the registry were invited. Frequency matching was used to sample HIV-negative controls from the general population according to the distribution of age, sex, and years of formal education of older people living with HIV. A total of 315 older people living with HIV and 350 HIV-negative controls completed the face-to-face interview and comprehensive neuropsychological assessment of seven domains (learning, memory, working memory, verbal fluency, processing speed, executive function, and motor skills).Results: As compared to HIV-negative controls, older people living with HIV performed worse in global score and all seven domains (P<.05). HIV infection was associated with higher depressive symptoms (P<.001) and lower level of physical activity (P<.001). Depressive symptoms and physical activity were negatively correlated (P<.001). Depressive symptoms and level of physical activity mediated the association between HIV status and global z-score and four domain z-scores of neurocognitive performance (learning, memory, verbal fluency, and processing speed).Conclusions: Change in mental health and physical activity after HIV infection may partially explain why older people living with HIV are more susceptible to neurocognitive impairment. Promoting mental health and physical activity are potential entry points to slow down the progress of neurocognitive impairment among older people living with HIV.

AB - Background: Neurocognitive impairments are prevalent among older people in China. It is more problematic among older people living with HIV.Objective: This study aims to compare neurocognitive performance between older people living with HIV and HIV-negative controls, and to explore whether the association between HIV status and neurocognitive performance was mediated by depressive symptoms and level of physical activity.Methods: A cross-sectional study was conducted in Yongzhou, China. All people living with HIV aged ≥50 years listed in the registry were invited. Frequency matching was used to sample HIV-negative controls from the general population according to the distribution of age, sex, and years of formal education of older people living with HIV. A total of 315 older people living with HIV and 350 HIV-negative controls completed the face-to-face interview and comprehensive neuropsychological assessment of seven domains (learning, memory, working memory, verbal fluency, processing speed, executive function, and motor skills).Results: As compared to HIV-negative controls, older people living with HIV performed worse in global score and all seven domains (P<.05). HIV infection was associated with higher depressive symptoms (P<.001) and lower level of physical activity (P<.001). Depressive symptoms and physical activity were negatively correlated (P<.001). Depressive symptoms and level of physical activity mediated the association between HIV status and global z-score and four domain z-scores of neurocognitive performance (learning, memory, verbal fluency, and processing speed).Conclusions: Change in mental health and physical activity after HIV infection may partially explain why older people living with HIV are more susceptible to neurocognitive impairment. Promoting mental health and physical activity are potential entry points to slow down the progress of neurocognitive impairment among older people living with HIV.

KW - depression

KW - depressive symptoms

KW - HIV

KW - HIV sero-status

KW - level of physical activity

KW - mediation effects

KW - mental health

KW - neurocognitive

KW - neurocognitive performance

KW - physical activity

KW - public health

UR - http://www.scopus.com/inward/record.url?scp=85137009178&partnerID=8YFLogxK

U2 - 10.2196/32968

DO - 10.2196/32968

M3 - Journal article

SN - 2369-2960

VL - 8

JO - JMIR Public Health and Surveillance

JF - JMIR Public Health and Surveillance

IS - 8

M1 - e32968

ER -

The Role of Depressive Symptoms and Physical Activity Levels in Mediating the Association Between HIV Status and Neurocognitive Functions Among Individuals Aged at Least 50 Years in China: Cross-sectional Study

Abstract

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