How does fatigue affect cognitive function in people living with HIV?

With age, all of us get tired more quickly. This can interfere with everyday tasks, impact out mental health and affect our overall quality of life. According to experts from the University of California, fatigue and functional disorders “disproportionately affect” people living with HIV (PLHIV).

“In people with HIV, the level of fatigue ranges from 30% to 88%” says Dr Raeanne Moore.

Dr Moore and her colleagues studied the relationship between fatigue and cognitive impairment in a cohort of PLHIV. The results were published in the journal Medscape.

The research team asked participants to take a series of tests assessing their cognitive function and performance-based functional abilities. During this analysis the team took into account the known indicators for fatigue, depression, anxiety and sleep quality over a four-week period. 105 people aged 50 to 74 took part in the study - 69 of them were living with HIV and 36 HIV-negative individuals to act as a control group.

The results showed that fatigue is much more common in PLHIV than the HIV-negative control group (P < 0.001), including the 94% of participants who were taking antiretroviral treatment. Also, fatigue in the PLHIV group was often associated with deterioration of health (P=0.003). This relationship remained high even after taking into account their current levels of depression, anxiety and sleep quality (P=0.005).

Fatigue in PLHIV largely linked to cognitive indications which affect our speed of processing information.

“Our processing speed tasks have both motor and non-motor components, and, as a rule, in people with depression or sleep disorders we see psychomotor deceleration or a very low processing speed," the authors explained.

Fatigue also affected the daily performance of tasks amongst participants living with HIV. In the worst cases this made daily tasks and personal management (such as taking medication and handling basic finances) very challenging.

At this point in time the biological causes of HIV have not yet been determined, which makes the development of treatments and strategies difficult. But experts believe that behavioural strategies can be of assistance. For example, planning certain tasks for specific periods of the day when the PLHIV feels their best. Daily routines such as scheduled ten-minute walks and healthy snacks can also provide a boost.

For now, the experts advise physical activity, healthy eating and good quality sleep can help PLHIV “maintain brain health in general”.