INS NYC 2024 Program

Poster	Poster Session 09 Program Schedule 02/16/2024 03:30 pm - 04:45 pm Room: Shubert Complex (Posters 1-60) Poster Session 09: Epilepsy \| Oncology \| MS \| Infectious Disease Final Abstract #52 Exploring Cardiovascular Risk as a Mediator of the Relationship Between Perceived Racial Discrimination and Cognitive Performance in Black Adults Living with HIV Valerie Humphreys, Drexel University, Philadelphia, United States William Dampier, Drexel University, Philadelphia, United States Shinika Tillman, Drexel University, Philadelphia, United States Kim Malone, Drexel University, Philadelphia, United States Vanessa Pirrone, Drexel University, Philadelphia, United States Michael Nonnemacher, Drexel University, Philadelphia, United States Amy Althoff, Drexel University, Philadelphia, United States Zsofia Szep, University of Pennsylvania, Philadelphia, United States Brian Wigdahl, Drexel University, Philadelphia, United States Maria Schultheis, Drexel University, Philadelphia, United States Kathryn Devlin, Drexel University, Philadelphia, United States Category: Infectious Disease (HIV/COVID/Hepatitis/Viruses) Keyword 1: cross-cultural issues Keyword 2: cardiovascular disease Keyword 3: cognitive functioning Objective: Black Americans face higher rates of HIV-associated neurocognitive disorders and HIV-related medical comorbidities, such as cardiovascular (CV) conditions, that compromise cognition. Social disadvantages contribute to these cognitive health disparities, namely racial and ethnic discrimination. In order to mitigate cognitive impairment in Black people living with HIV (PLWH), it is essential to investigate its underlying mechanisms that include experiences of racial discrimination. Discrimination may be a distal socially patterned predictor that induces stress responses and leads to CV risk, the most proximal mediator to cognitive impairment. The current study examines the effect of racial discrimination on cognitive performance among Black PLWH and investigates whether cardiovascular risk mediates this relationship. Participants and Methods: A sample of 54 Black adults living with HIV (ages 32-77, M=57.6, SD=7.5; 100% on antiretroviral therapy; 94% with undetectable viral load) were selected from the Temple/Drexel Comprehensive NeuroHIV Center, Clinical and Translational Research Support Core (CTRSC) Cohort, based at Drexel University College of Medicine. Visits included biometric measurements, a medical history interview and chart review, comprehensive neuropsychological assessments, and questionnaires including the Perceived Ethnic Discrimination Questionnaire - Community Version. Cardiovascular risk factors of interest were body mass index (BMI), waist-to-height ratio (WHtR), and a total vascular risk burden score representing five risk factors: obesity, central obesity, diabetes, hyperlipidemia, and hypertension. Performance in seven neurocognitive domains was assessed. Mediation models were used to investigate the relationships between discrimination, CV risk, and cognition. Results: Greater perceptions of race-based discrimination determined by PEDQ-CV scores displayed a trending association with cognitive performance exclusively in the complex executive functioning domain (β=-0.39, p=.06). Exploration of PEDQ-CV domains indicated that this association was driven primarily by the stigmatization/devaluation subscale (β=-0.45, p=.03) and, to a lesser degree, the work/school discrimination domain (β=-0.35, p=.07). CV risk was not related to discrimination or cognitive performance in this sample and did not mediate this relationship. Conclusions: The present findings are broadly in line with prior evidence that experiences of racial discrimination contribute to the mild, heterogeneous profiles of cognitive impairment observed in Black PLWH. The relationship between race-based maltreatment and complex executive performance corroborates the deleterious executive effects of lifetime exposure to racism in Black PLWH. The lack of CV risk associations with discrimination and cognition was unexpected, given its established role in the incidence and progression of cognitive impairment. Additionally, experiences of racism place Black Americans at higher risk of these adverse CV and cognitive outcomes. Future studies should therefore continue investigating the pathways through which institutional and interpersonal discrimination impair cognitive abilities in this population.

Poster

02/16/2024
03:30 pm - 04:45 pm
Room: Shubert Complex (Posters 1-60)

Poster Session 09: Epilepsy | Oncology | MS | Infectious Disease

Final Abstract #52

Exploring Cardiovascular Risk as a Mediator of the Relationship Between Perceived Racial Discrimination and Cognitive Performance in Black Adults Living with HIV

Valerie Humphreys, Drexel University, Philadelphia, United States
William Dampier, Drexel University, Philadelphia, United States
Shinika Tillman, Drexel University, Philadelphia, United States
Kim Malone, Drexel University, Philadelphia, United States
Vanessa Pirrone, Drexel University, Philadelphia, United States
Michael Nonnemacher, Drexel University, Philadelphia, United States
Amy Althoff, Drexel University, Philadelphia, United States
Zsofia Szep, University of Pennsylvania, Philadelphia, United States
Brian Wigdahl, Drexel University, Philadelphia, United States
Maria Schultheis, Drexel University, Philadelphia, United States
Kathryn Devlin, Drexel University, Philadelphia, United States

Category: Infectious Disease (HIV/COVID/Hepatitis/Viruses)

Keyword 1: cross-cultural issues
Keyword 2: cardiovascular disease
Keyword 3: cognitive functioning

Objective:

Black Americans face higher rates of HIV-associated neurocognitive disorders and HIV-related medical comorbidities, such as cardiovascular (CV) conditions, that compromise cognition. Social disadvantages contribute to these cognitive health disparities, namely racial and ethnic discrimination. In order to mitigate cognitive impairment in Black people living with HIV (PLWH), it is essential to investigate its underlying mechanisms that include experiences of racial discrimination. Discrimination may be a distal socially patterned predictor that induces stress responses and leads to CV risk, the most proximal mediator to cognitive impairment. The current study examines the effect of racial discrimination on cognitive performance among Black PLWH and investigates whether cardiovascular risk mediates this relationship.

Participants and Methods:

A sample of 54 Black adults living with HIV (ages 32-77, M=57.6, SD=7.5; 100% on antiretroviral therapy; 94% with undetectable viral load) were selected from the Temple/Drexel Comprehensive NeuroHIV Center, Clinical and Translational Research Support Core (CTRSC) Cohort, based at Drexel University College of Medicine. Visits included biometric measurements, a medical history interview and chart review, comprehensive neuropsychological assessments, and questionnaires including the Perceived Ethnic Discrimination Questionnaire - Community Version. Cardiovascular risk factors of interest were body mass index (BMI), waist-to-height ratio (WHtR), and a total vascular risk burden score representing five risk factors: obesity, central obesity, diabetes, hyperlipidemia, and hypertension. Performance in seven neurocognitive domains was assessed. Mediation models were used to investigate the relationships between discrimination, CV risk, and cognition.

Results:

Greater perceptions of race-based discrimination determined by PEDQ-CV scores displayed a trending association with cognitive performance exclusively in the complex executive functioning domain (β=-0.39, p=.06). Exploration of PEDQ-CV domains indicated that this association was driven primarily by the stigmatization/devaluation subscale (β=-0.45, p=.03) and, to a lesser degree, the work/school discrimination domain (β=-0.35, p=.07). CV risk was not related to discrimination or cognitive performance in this sample and did not mediate this relationship.

Conclusions:

The present findings are broadly in line with prior evidence that experiences of racial discrimination contribute to the mild, heterogeneous profiles of cognitive impairment observed in Black PLWH. The relationship between race-based maltreatment and complex executive performance corroborates the deleterious executive effects of lifetime exposure to racism in Black PLWH. The lack of CV risk associations with discrimination and cognition was unexpected, given its established role in the incidence and progression of cognitive impairment. Additionally, experiences of racism place Black Americans at higher risk of these adverse CV and cognitive outcomes. Future studies should therefore continue investigating the pathways through which institutional and interpersonal discrimination impair cognitive abilities in this population.