Intersectionality of Socioecological Factors Associated With Cognitive Function Among Older Women With HIV in the United States: A Structural Equation Model Analysis Using Data From the Women's Interagency HIV Study.
Veronica P S Njie-Carr, Shijun Zhu, Kristen A Stafford and 11 others
PMID 36656093WHAT IT FOUND
In older women with HIV, mood, abuse, comorbidities, and substance use were linked to cognitive test scores.
Depression and smoking tracked with poorer thinking and speed; abuse unexpectedly tracked with better scores.
Key findings
01In the final model, overall cognitive function was directly associated with mood, comorbidities, race, and abuse.
02Substance use was indirectly associated with cognitive function through mood, and smoking was negatively associated with processing speed.
03Higher depressive symptom scores were associated with lower executive function and processing speed, while social isolation was associated with poorer motor function.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
This was a cross-sectional analysis, so it can show associations at one time point but cannot show that any factor caused cognitive change or that scores changed over time. Women without HIV were removed because the sample was not adequately powered to compare HIV serostatus, so the paper cannot say how these women differed from women without HIV. The sample was limited to women with HIV aged 50 years and older, so findings may not apply to younger women or men. Other racial groups and women aged 60 years and older were too small for separate comparisons, and race categories were combined, which may hide differences. The positive association between abuse and cognitive function was unexpected, and the paper cannot explain why it occurred.
Declared interests
The authors declared no real or perceived vested interests related to this article that could be construed as a conflict of interest.
The easy way to misread this
Do not conclude that abuse, substance use, or depression caused cognitive impairment in older women with HIV. This was a cross-sectional analysis of associations, and the abuse link with cognitive function was positive and unexpected.