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 #46 Latent profile analysis of cognitive performance and depressive symptoms among people with HIV Maulika Kohli, San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology, San Diego, United States Lillian Ham, San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology, San Diego, United States Rowan Saloner, University of California, San Francisco, San Francisco, United States Devin Dung, HIV Neurobehavioral Research Program, University of California San Diego, San Diego, United States Jennifer Iudicello, Department of Psychiatry, University of California San Diego, San Diego, United States Ronald Ellis, Department of Neurosciences, University of California San Diego, San Diego, United States David Moore, Department of Psychiatry, University of California San Diego, San Diego, United States Category: Infectious Disease (HIV/COVID/Hepatitis/Viruses) Keyword 1: cognitive functioning Keyword 2: depression Keyword 3: HIV/AIDS Objective: Objective: Depression and cognitive impairment are prevalent and frequently co-occurring conditions among people with HIV (PWH), likely attributable to shared causes (e.g., inflammation, neural pathways) and common risk factors. Identifying subtypes of PWH with similar patterns of neurocognitive impairment (NCI) and depressive symptoms may inform the development of patient-centered interventions that target specific symptom profiles. Therefore, this study applied latent profile analysis to 1) classify PWH based on patterns of domain-specific NCI and depression; and 2) determine the relationship between latent class membership and pertinent clinical characteristics. Participants and Methods: Participants and Methods: 580 PWH [Mean age = 52.5 years (age range: 18-87)] completed a comprehensive neuropsychological test battery assessing global and domain-specific cognition. Domain-specific NCI was classified using a validated deficit score cut-point of > 0.5. Participants completed the Beck Depression Inventory-II (BDI-II) and domain-specific BDI-II scores reflecting cognitive, affective, and somatic symptoms were computed. Latent profile analysis (LPA) was used to determine latent subgroups of NCI and depression. ANOVAs and chi-square tests with follow-up pairwise comparisons examined latent class differences on demographic, medical, neuropsychiatric, and daily functioning factors. Results: Results: The optimal LPA solution, based on statistical fit indices and interpretability, consisted of five classes: minimal NCI and minimal depression (Class 1), amnestic and minimal depression (Class 2), severe multi-domain NCI and moderate depression (somatic and affective) (Class 3), mild NCI and mild depression (Class 4), and moderate multi-domain NCI and severe depression (Class 5). Despite similar levels of functional impairment (i.e., IADLs and employment), Class 5 had a stronger psychiatric profile (i.e., higher BDI scores, current major depressive disorder), whereas Class 3 has a stronger medical profile (i.e., higher frailty index, higher medications, greater proportion of AIDS diagnosis). In contrast, Class 1 had the lowest medication use and frailty index, with similar HIV disease characteristics to Classes 3 and 5. Conclusions: Conclusions: Our results suggest there are multiple pathways to cognitive and functional impairment among PWH with co-occurring depression and cognitive impairment, and these groups may respond to different interventions. Future interventions should consider a more integrated, person-centered approach that addresses both cognitive and emotional health to optimize overall health outcomes in PWH. Moreover, our findings underscore the need for routine neuropsychiatric assessment in HIV care settings to identify and address mental health symptoms that may impede optimal daily functioning and medication adherence. Tailoring interventions according to the cognitive and mood profiles of individuals could potentially enhance their effectiveness and acceptability.

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 #46

Latent profile analysis of cognitive performance and depressive symptoms among people with HIV

Maulika Kohli, San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology, San Diego, United States
Lillian Ham, San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology, San Diego, United States
Rowan Saloner, University of California, San Francisco, San Francisco, United States
Devin Dung, HIV Neurobehavioral Research Program, University of California San Diego, San Diego, United States
Jennifer Iudicello, Department of Psychiatry, University of California San Diego, San Diego, United States
Ronald Ellis, Department of Neurosciences, University of California San Diego, San Diego, United States
David Moore, Department of Psychiatry, University of California San Diego, San Diego, United States

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

Keyword 1: cognitive functioning
Keyword 2: depression
Keyword 3: HIV/AIDS

Objective:

Objective: Depression and cognitive impairment are prevalent and frequently co-occurring conditions among people with HIV (PWH), likely attributable to shared causes (e.g., inflammation, neural pathways) and common risk factors. Identifying subtypes of PWH with similar patterns of neurocognitive impairment (NCI) and depressive symptoms may inform the development of patient-centered interventions that target specific symptom profiles. Therefore, this study applied latent profile analysis to 1) classify PWH based on patterns of domain-specific NCI and depression; and 2) determine the relationship between latent class membership and pertinent clinical characteristics.

Participants and Methods:

Participants and Methods: 580 PWH [Mean age = 52.5 years (age range: 18-87)] completed a comprehensive neuropsychological test battery assessing global and domain-specific cognition. Domain-specific NCI was classified using a validated deficit score cut-point of > 0.5. Participants completed the Beck Depression Inventory-II (BDI-II) and domain-specific BDI-II scores reflecting cognitive, affective, and somatic symptoms were computed. Latent profile analysis (LPA) was used to determine latent subgroups of NCI and depression. ANOVAs and chi-square tests with follow-up pairwise comparisons examined latent class differences on demographic, medical, neuropsychiatric, and daily functioning factors.

Results:

Results: The optimal LPA solution, based on statistical fit indices and interpretability, consisted of five classes: minimal NCI and minimal depression (Class 1), amnestic and minimal depression (Class 2), severe multi-domain NCI and moderate depression (somatic and affective) (Class 3), mild NCI and mild depression (Class 4), and moderate multi-domain NCI and severe depression (Class 5). Despite similar levels of functional impairment (i.e., IADLs and employment), Class 5 had a stronger psychiatric profile (i.e., higher BDI scores, current major depressive disorder), whereas Class 3 has a stronger medical profile (i.e., higher frailty index, higher medications, greater proportion of AIDS diagnosis). In contrast, Class 1 had the lowest medication use and frailty index, with similar HIV disease characteristics to Classes 3 and 5.

Conclusions:

Conclusions: Our results suggest there are multiple pathways to cognitive and functional impairment among PWH with co-occurring depression and cognitive impairment, and these groups may respond to different interventions. Future interventions should consider a more integrated, person-centered approach that addresses both cognitive and emotional health to optimize overall health outcomes in PWH. Moreover, our findings underscore the need for routine neuropsychiatric assessment in HIV care settings to identify and address mental health symptoms that may impede optimal daily functioning and medication adherence. Tailoring interventions according to the cognitive and mood profiles of individuals could potentially enhance their effectiveness and acceptability.