Low education as a possible risk factor for cognitive abnormalities in HIV–1: Findings from the multicenter aids cohort study (MACS)

Paul Satz, Hal Morgenstern, Eric N. Miller, Ola A. Selnes, Justin C. McArthur, Bruce A. Cohen, Jerry Wesch, James T. Becker, Lisa Jacobson, Louis F. D’Elia, Wilfred van Gorp, Barbara Visscher

Research output: Contribution to journalArticlepeer-review

149 Scopus citations

Abstract

The present study reports new and unexpected results of cognitive abnormalities among human immunodeficiency virus type 1 (HIV–1) asymptomatic subjects in the Multicenter AIDS Cohort Study. The major purpose of our analyses is to estimate the separate and combined effects of serostatus and education level on the prevalence of cognitive abnormality. Cognitive “abnormality” was defined as performance that deviated ≥2 SDs below the mean of the total seronegative group on at least one of the five neuropsychological screening tests (Grooved Pegboard, Verbal Fluency, Digit Span, Symbol Digit Modalities, Rey Auditory Verbal Learning). The predicted prevalence of cognitive abnormality was 38% in seropositive individuals with no more than 12 years of education, compared with <17% in the other education–serostatus groups. This interaction between education level and serostatus remained after controlling for the possible confounding effects of age, ethnicity, CD4 level, depression, prior drug history, and learning disability using logistic regression. To account for these findings, we suggest that low education might reflect an indirect index of lower reserve capacity (i.e., a risk factor) that lowers the threshold for neuropsychological abnormalities in cases of early HIV–1 infection.

Original languageEnglish (US)
Pages (from-to)503-509
Number of pages7
JournalJournal of Acquired Immune Deficiency Syndromes
Volume6
Issue number5
StatePublished - May 1993

Keywords

  • Asymptomatic subjects
  • Education
  • HIV
  • Neuropsychology
  • Risk factors

ASJC Scopus subject areas

  • Infectious Diseases
  • Pharmacology (medical)

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