Cardiovascular Contributors to Cognitive Impairment Among People Living With HIV Age 40 Years and Older in Kazakhstan

Abstract

Introduction: The Kazakh population has been increasing in age over the last two decades. Life expectancy in Kazakhstan in 2022 was 73.8 years (y). Noncommunicable diseases (NCDs) accounted for ∼84% of deaths, particularly among men, and included cardiovascular disease, diabetes, chronic respiratory disease and cancer. It is anticipated that life expectancy trends will be similar among People Living With HIV (PLWH) who are virally suppressed in Kazakhstan. However, the prevalence and types of aging-related NCDs among Kazakh PLWH are unknown, despite ∼40% of Kazakh PLWH being age >40 years (y). In addition, and limited knowledge exists about the NCD-HIV care continuum. Methods: An ongoing cross-sectional study is being conducted among PLWH, >40y at the Almaty AIDS center. Cardiovascular, clinical, sociodemographic, mental health, medical history, health behavior, and HIV measures are collected. The Montreal Cognitive Assessment was included (range: 0-30). Results: 113 PLWH were interviewed over ∼6 months (43.4% females; 54.9% age 40-49y, 30.1%, 11.5% and 3.5% age 50-59, 60-69, >70 years, respectively; gender: 58.3% cis men, 41.7% cis women; 20.4% self-reported Asian (Kazakh) race, 56.6% White (Russian), 23.0% unknown; 55.4% were employed; 25.7% reported education beyond college; 65.5% consumed alcohol; 76.1% were current smokers and 26.5% drug users. 54% had healthy BMI (18.5- 0.05. The MoCA indicated that 61.9% scored <26 (raw score); average 23.1. Comparing those with MoCA <26 versus ≥26, there were no differences in pro-BNP or lipid levels, HIV viral load or CD4+ count. However, diastolic blood pressure was higher among those with MoCA<26 (p=0.043). Discussion: Further investigation to understand cardiovascular contributors to cognitive impairment among PLWH is necessary.