{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,8]],"date-time":"2025-10-08T22:32:44Z","timestamp":1759962764732,"version":"3.40.5"},"reference-count":50,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2020,7,20]],"date-time":"2020-07-20T00:00:00Z","timestamp":1595203200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J Geriat Psychiatry"],"published-print":{"date-parts":[[2020,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>HIV\u2010associated neurocognitive disorder (HAND), although prevalent, remains a poorly researched cause of morbidity particularly in sub\u2010Saharan Africa (SSA). We aimed to explore the risk factors for HAND in people aged 50 and over under regular follow\u2010up at a government HIV clinic in Tanzania.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>HIV\u2010positive adults aged 50\u2009years and over were approached for recruitment at a routine HIV clinic appointment over a 4\u2010month period. A diagnostic assessment for HAND was implemented, including a full medical\/neurological assessment and a collateral history from a relative. We investigated potential risk factors using a structured questionnaire and by examination of clinic records.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the cohort (n = 253), 183 (72.3%) were female and the median age was 57\u2009years. Fifty\u2010five individuals (21.7%) met the criteria for symptomatic HAND. Participants were at a greater risk of having symptomatic HAND if they lived alone [odds ratio (OR) = 2.566, <jats:italic>P<\/jats:italic> =\u2009.015], were illiterate (OR 3.171, <jats:italic>P<\/jats:italic> =\u2009.003) or older at the time of HIV diagnosis (OR = 1.057, <jats:italic>P<\/jats:italic> =\u2009.015). Age was correlated with symptomatic HAND in univariate, but not multivariate analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In this setting, HIV\u2010specific factors, such as nadir CD4 count, were not related to symptomatic HAND. The \u201clegacy theory\u201d of early central nervous system damage prior to initiation of anti\u2010retroviral therapy initiation may contribute, only in part, to a multifactorial aetiology of HAND in older people. Social isolation and illiteracy were associated with symptomatic HAND, suggesting greater cognitive reserve might be protective.<\/jats:p><\/jats:sec>","DOI":"10.1002\/gps.5357","type":"journal-article","created":{"date-parts":[[2020,6,4]],"date-time":"2020-06-04T17:46:53Z","timestamp":1591292813000},"page":"1198-1208","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Risk factors for symptomatic <scp>HIV<\/scp>\u2010associated neurocognitive disorder in adults aged 50 and over attending a <scp>HIV<\/scp> clinic in Tanzania"],"prefix":"10.1002","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4178-1312","authenticated-orcid":false,"given":"Patrick","family":"Eaton","sequence":"first","affiliation":[{"name":"The Medical School Newcastle University  Newcastle upon Tyne 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Tanzania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jessica","family":"Thornton","sequence":"additional","affiliation":[{"name":"The London School of Hygiene and Tropical Medicine  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Judith","family":"McCartney","sequence":"additional","affiliation":[{"name":"The London School of Hygiene and Tropical Medicine  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vanessa","family":"Yarwood","sequence":"additional","affiliation":[{"name":"The London School of Hygiene and Tropical Medicine  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Charlotte","family":"Irwin","sequence":"additional","affiliation":[{"name":"The London School of Hygiene and Tropical Medicine  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elizabeta B.","family":"Mukaetova\u2010Ladinska","sequence":"additional","affiliation":[{"name":"Department of 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