Veterans Aging Cohort Study (VACS) index score are associated with cognition and HAND symptoms: A CHARTER Study.

Type: Poster
Title: Veterans Aging Cohort Study (VACS) index score are associated with cognition and HAND symptoms: A CHARTER Study.
Authors: Franklin D, Heaton R, Woods S, Letrendre S, Collier A, Clifford D, Gelman B, McArthur J, Simpson J, Grant I
Date: 03-05-2013
Abstract:Background: Combination antiretroviral therapy has caused those living with HIV to live longer, experience fewer AIDS-defining illnesses, and also experience more non-AIDS illnesses. The Veterans Aging Cohort Study (VACS) Index combines both AIDS and non-AIDS factors into a single index that is associated with mortality risk in HIV-infected subjects, but it’s association with neuroAIDS has not been explored. Methods: The current study investigated the association being VACS Index score and cognitive and functional measures in a group of HIV-infected individuals receiving care at 6 university-affiliated clinics in CHARTER. Participants received comprehensive laboratory, neuromedical and neurobehavioral assessments, which included both self-report and performance based measures of symptoms of HIV-associated neurocognitive disorders (HAND). VACS Index score were compared among impaired vs. non-impaired (globally and domain-specific) and symptomatic vs. non-symptomatic (self-report and performance-based) to explore associations between VACS Index and neuroAIDS. Results: VACS Index score was associated with impairment in speed of information processing (SIP) and delayed recall with impaired subjects having higher scores than the unimpaired (SIP: 24.0(15.9) vs. 20.1(16.2) p=.009; Delayed Recall: 23.0(17.7) vs. 19.9(15.7), p=.03). VACS Index score was not related to any other cognitive domain or global functioning. VACS Index score was also associated with functional symptoms of HAND as measured by self-report (SR) and performance-based (PB) measures with higher VACS Index scores in those who are symptomatic (SR: 22.2(16.6) vs. 17.9(14.1), p=.04; PB: 24.6(16.4) vs. 17.7(14.1), p=.0007). In addition, unemployed subjects had higher VACS Index scores than employed subjects (21.7(15.5) vs. 14.5(12.4), p<.0001). Conclusions: VACS Index scores are associated with both cognitive function and symptoms of HAND, especially performance-based functional impairment. Findings suggest that VACS Index score may be a useful tool in assessing risk for HAND and that studies assessing the relationship between neurocognitive change and VACS index are warranted.