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Menopause. 2014 Sep;21(9):997-1006. doi: 10.1097/GME.0000000000000203.

Investigation of menopausal stage and symptoms on cognition in human immunodeficiency virus-infected women.

Author information

1
From the 1Department of Psychiatry, University of Illinois at Chicago, Chicago, IL; 2Department of Psychiatry, Rush University, Chicago, IL; 3Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, MD; 4The Core Center, Cook County Health and Hospital System and Hektoen Institute of Medicine, Chicago, IL; 5Department of Medicine, Stroger Hospital and Rush University, Chicago, IL; 6Department of Neurology, SUNY Downstate Medical Center, Brooklyn, NY; 7School of Social Work, University of Southern California, Los Angeles, CA; 8Department of Medicine and Epidemiology, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, NY; 9Georgetown University School of Medicine, Washington, DC; 10Departments of Clinical Pharmacy, Medicine, Epidemiology, and Biostatistics, University of California, San Francisco, CA; and 11Department of Psychology, University of Illinois at Chicago, Chicago, IL.

Abstract

OBJECTIVE:

We evaluated the separate and interactive associations of menopausal stage, menopausal symptoms, and human immunodeficiency virus (HIV) infection with cognition. We hypothesized that HIV-infected perimenopausal women would show the greatest cognitive difficulties and that menopausal symptoms would be inversely associated with cognition.

METHODS:

This cross-sectional study included 708 HIV-infected and 278 HIV-uninfected premenopausal, perimenopausal, or postmenopausal women (64% African American; median age, 44 y) from the Women's Interagency HIV Study. Participants completed tests of verbal learning and memory, attention/processing speed, and executive function. We administered a menopausal symptom questionnaire that assessed anxiety, vasomotor, and sleep symptoms and obtained measures of depressive symptoms.

RESULTS:

In multivariable regression analyses controlling for relevant covariates, HIV infection, but not menopausal stage, was associated with worse performance on all cognitive measures (P's < 0.05). Depressive symptoms were associated with lower cognitive performance on measures of verbal learning and memory, attention, and executive function (P's < 0.05); anxiety symptoms were associated with lower performance on measures of verbal learning and memory (P's < 0.05). Vasomotor symptoms were associated with worse attention (P < 0.05). HIV and anxiety symptoms interacted to influence verbal learning (P's < 0.05); elevated anxiety was associated with worse verbal learning in HIV-infected women only.

CONCLUSIONS:

Vasomotor, depressive, and anxiety symptoms, but not menopausal stage, are associated with worse cognitive performance in both HIV-infected and HIV-uninfected women, although elevated anxiety symptoms are more associated with verbal learning deficits in HIV-infected women. Because cognitive problems can interfere with everyday functioning, including treatment adherence, it may be important to screen and treat anxiety in HIV-infected women.

PMID:
24496085
PMCID:
PMC4119867
DOI:
10.1097/GME.0000000000000203
[Indexed for MEDLINE]
Free PMC Article

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