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Mild Cognitive Impairment and Risk of Mortality in HIV-1 Infection

Received August 8, 1996; revised January 27, 1997; accepted March 5, 1997. From the Departments of Psychiatry and Behavioral Sciences, Medicine, Psychology, Neurology, and Epidemiology, University of Miami School of Medicine, Miami, Florida. Address correspondence to Dr. Wilkie, Department of Psychiatry and Behavioral Sciences (M836), 1400 NW 10th Ave., #803-A, University of Miami School of Medicine, Miami, FL 33136.

HIV-1–associated cognitive impairment has only been preliminarily investigated for associations with mortality. The authors examined 119 HIV-1–positive homosexual men (asymptomatic: n=96; early symptomatic: n=23). At follow-up (to 3.5 years), there were 105 survivors and 14 nonsurvivors. Those at the 25th percentile in response speeds and in long-term memory retrieval accuracy were at 6.4 (P<0.02) and 3.5 (P<0.05) times increased mortality risk, respectively, of those at the 75th percentile—independent of baseline CDC clinical stage, CD4 cell count, hemoglobin level, antiretroviral and prophylactic medication use, and sociodemographics. Cognitive impairment should be identified early—for maximization of both functional status and survival time.

Key Words: Human Immunodeficiency Virus–Type 1 • Mortality • Cognitive Impairment, Mild

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