RISK FACTORS OF EARLY-ONSET DEMENTIA AMONG PEOPLE LIVING WITH HIV/AIDS- A CLAIMS DATA ANALYSIS

OBJECTIVES : Prior work suggests that HIV infection may increase the risk and speed the onset of dementia, but that successful viral load suppression may mitigate or prevent cognitive impairment. Prior work suggests that onset may also vary by demographic characteristics. Early-onset dementia is defined as all the dementia-related conditions that occur under age 65. This study examines the potential risk factors of early-onset dementia among people living with HIV/AIDS (PLWHA) covered by a private insurance.

METHODS : This study used Optum Clinformatics Data Mart from 2007-2016. Enrollees aged 20-64 were included. Exclusion criteria were enrollment in Medicare and less than 1-year of enrollment in private insurance. All health conditions were identified by ICD-9/ICD-10 codes. Early-onset dementia included non-Alzheimer’s dementia, Alzheimer’s dementia, and cognitive impairment. Logistic regressions were used to examine the potential risk factors of early-onset dementia among PLWHA. Explanatory variables included were gender, race, year of birth, education level, and income level.

RESULTS : A total of 44,940 PLWHA aged 20-64 were included in Optum during the period 2007-2016. A younger age was associated with a smaller risk of developing early-onset dementia (non-Alzheimer’s dementia OR: 0.92; Alzheimer’s dementia OR: 0.93; cognitive impairment OR: 0.94; all statistically significant at p-value<0.05). Being African-American was associated with smaller risk of developing early-onset cognitive impairment (OR: 0.82; p=0.07; statistically significant at p-value<0.1). Odds ratios for male, education level, and income level were all not statistically significant.

CONCLUSIONS : Aging is a potential risk factor of developing early-onset dementia even in PLWHA under age 64 in this private insurance dataset. Although the odds ratios for male, race, education level, and income level, may not be statistically significant in all 3 examined dementia-related conditions, we cannot preclude their involvement in early-onset dementia among PLWHA. Further investigation is needed to explore potential risk factors of early-onset dementia among PLWHA.