Physical activity may protect against cognitive impairment in women living with HIV, according to a recent study published in the Journal of Infectious Disease.

Researchers completed a cross-sectional analysis of the HIV Infection, Aging, and Immune Function Long-Term Observational Study for a neurocognitive evaluation to analyze the relationship between cardiometabolic risk factors and cognitive impairment. Data collection included demographic information, neuropsychological tests, laboratory data, physical examinations, medication usage, and physical activity questionnaires.

Of the participants (N=988), the average age was 52 years old, 20% were female, 49% were white, 49% had achieved a college degree, 90% had an undetectable HIV-viral load, and women had a higher CD4 count than men (747 cells/mm3 vs 639 cells/mm3, P <.001).

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Cardiovascular risk factors included 36% of the cohort on an anti-hypertensive medication, 27% of the cohort on a statin, and 13% of the cohort with diabetes mellitus. Women had higher total cholesterol (P =.027), hemoglobin A1c (P=.078), body mass index, and waist circumference when compared to men. Women were also less likely to be physically active (P =.005) and more likely to meet the criteria for cognitive impairment (P =.003).

As a whole cohort, having HDL greater than 55 mg/dL decreased the risk for cognitive impairment by 40% (OR, 0.59; 95% CI, 0.40-0.88; P =.009), but this association was not significant when broken down by sex.

In a logistic regression model, physical activity was a protectant against cognitive impairment in women (OR, 0.33; P =.003), and in a multivariable model, physical activity had a significant relationship with decreasing the risk of cognitive impairment in women (P =.049).

Future studies need to address causality and potential unmeasured confounders and increase the number of women included in the sample size.

In conclusion, sex-related differences do appear to exist in the relationship between cardiometabolic risk factors and cognitive impairment. The ability of physical activity to reduce the risk of cognitive impairment is a practical way to improve the health of women living with HIV.

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Disclosures: This study was supported by the Fogarty International Center and National Institute of Mental Health of the National Institutes of Health. Please refer to reference for a complete list of authors’ disclosures.


Chow FC, Makanjuola A, Wu K, et al. Physical activity is associated with lower odds of cognitive impairment in women but not men living with HIV infection [published online Aug. 18, 2018]. J Infect Dis. doi: 10.1093/infdis/jiy503