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Independent and combined adverse effects of neurocognitive impairment and depression on everyday functioning and quality of life in people with HIV

Published online by Cambridge University Press:  29 April 2025

Crystal X. Wang Open the ORCID record for Crystal X. Wang [Opens in a new window] ,
Victoria O. Chentsova ,
Maximo R. Prescott ,
Anya Umlauf ,
David J. Moore ,
Ronald J. Ellis ,
Mariana Cherner ,
Murray B. Stein ,
Scott L. Letendre  and
Robert K. Heaton
...Show all authors
Crystal X. Wang*
Affiliation:
Department of Psychiatry, University of California, San DiegoHIV Neurobehavioral Research Program, San Diego, CA, USA
Victoria O. Chentsova
Affiliation:
SDSU/UCSD Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA
Maximo R. Prescott
Affiliation:
SDSU/UCSD Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA
Anya Umlauf
Affiliation:
Department of Psychiatry, University of California, San DiegoHIV Neurobehavioral Research Program, San Diego, CA, USA
David J. Moore
Affiliation:
Department of Psychiatry, University of California, San DiegoHIV Neurobehavioral Research Program, San Diego, CA, USA
Ronald J. Ellis
Affiliation:
Department of Neurosciences, University of California, San Diego, CA, USA
Mariana Cherner
Affiliation:
Department of Psychiatry, University of California, San DiegoHIV Neurobehavioral Research Program, San Diego, CA, USA
Murray B. Stein
Affiliation:
Department of Psychiatry, University of California, San DiegoHIV Neurobehavioral Research Program, San Diego, CA, USA
Scott L. Letendre
Affiliation:
Department of Infectious Disease, University of California, San Diego, CA, USA
Robert K. Heaton
Affiliation:
Department of Psychiatry, University of California, San DiegoHIV Neurobehavioral Research Program, San Diego, CA, USA
Jennifer E. Iudicello
Affiliation:
Department of Psychiatry, University of California, San DiegoHIV Neurobehavioral Research Program, San Diego, CA, USA
*
Corresponding author: Crystal X. Wang; Email: [email protected]
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Abstract

Objective:

Despite advances in antiretroviral treatment (ART), human immunodeficiency virus (HIV) can detrimentally affect everyday functioning. Neurocognitive impairment (NCI) and current depression are common in people with HIV (PWH) and can contribute to poor functional outcomes, but potential synergies between the two conditions are less understood. Thus, the present study aimed to compare the independent and combined effects of NCI and depression on everyday functioning in PWH. We predicted worse functional outcomes with comorbid NCI and depression than either condition alone.

Methods:

PWH enrolled at the UCSD HIV Neurobehavioral Research Program were assessed for neuropsychological performance, depression severity (≤minimal, mild, moderate, or severe; Beck Depression Inventory-II), and self-reported everyday functioning.

Results:

Participants were 1,973 PWH (79% male; 66% racial/ethnic minority; Age: M = 48.6; Education: M = 13.0, 66% AIDS; 82% on ART; 42% with NCI; 35% BDI>13). ANCOVA models found effects of NCI and depression symptom severity on all functional outcomes (ps < .0001). With NCI and depression severity included in the same model, both remained significant (ps < .0001), although the effects of each were attenuated, and yielded better model fit parameters (i.e., lower AIC values) than models with only NCI or only depression.

Conclusions:

Consistent with prior literature, NCI and depression had independent effects on everyday functioning in PWH. There was also evidence for combined effects of NCI and depression, such that their comorbidity had a greater impact on functioning than either alone. Our results have implications for informing future interventions to target common, comorbid NCI and depressed mood in PWH and thus reduce HIV-related health disparities.

Keywords

HIV-associated neurocognitive impairmentdepressive symptomsmajor depressive disordereveryday functioningquality of lifeHIV comorbidities
Type
Research Article
Information
Journal of the International Neuropsychological Society , First View , pp. 1 - 10
Copyright
© The Author(s), 2025. Published by Cambridge University Press on behalf of International Neuropsychological Society

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