Abstract

Cognitive impairment is known to increase with aging in people living with HIV (PLWH). Impairment in cognitive domains required for safe driving may put PLWH at risk for poor driving outcomes, decreased mobility, and health-related quality of life (HRQoL). This study described the driving behaviors of middle-aged and older PLWH and examined correlations between driving behaviors and cognitive functioning (Aim 1), and driving behaviors and HRQoL domains (Aim 2). A sample of 260 PLWH ages 40 and older completed a comprehensive assessment including a battery of cognitive tests, an HRQoL measure, and a measure of self-reported driving habits. Associations between driving habits, cognitive function, and HRQoL domains were examined. While 212 (81.54%) participants reported currently driving, only 166 (63.85%) possessed a driver’s license. Several significant correlations emerged between driving habits and both cognitive and HRQoL variables, with a general pattern suggesting that current greater driving exposure was associated with better cognitive functioning and HRQoL. Given consistent associations that emerged between the social functioning HRQoL domain and several driving habits, multivariable regression was conducted to examine the unique association between an index of greater driving exposure (i.e., days driven per week) and social functioning, adjusting for potential confounders (race, income, education, depression, and global cognition). Results showed that more days driven per week was a significant, independent correlate of higher social functioning. Understanding the factors underlying driving behaviors in PLWH may contribute to interventions to promote better mobility and improved access to care.

摘要

众所周知，艾滋病毒感染者 (PLWH) 的认知障碍会随着年龄的增长而加剧。安全驾驶所需的认知领域受损可能会使 PLWH 面临驾驶结果不佳、行动能力下降和健康相关生活质量 (HRQoL) 的风险。本研究描述了中老年艾滋病患者的驾驶行为，并检验了驾驶行为与认知功能（目标 1）以及驾驶行为与 HRQoL 领域（目标 2）之间的相关性。260 名年龄在 40 岁及以上的 PLWH 样本完成了一项综合评估，包括一系列认知测试、HRQoL 测量以及自我报告的驾驶习惯测量。研究了驾驶习惯、认知功能和 HRQoL 领域之间的关联。虽然 212 名（81.54%）参与者报告目前正在驾驶，但只有 166 名（63.85%）拥有驾驶执照。驾驶习惯与认知和 HRQoL 变量之间存在一些显着的相关性，一般模式表明当前较多的驾驶暴露与更好的认知功能和 HRQoL 相关。鉴于社会功能 HRQoL 领域和几种驾驶习惯之间出现一致的关联，进行多变量回归来检查更多驾驶暴露指数（即每周驾驶天数）和社会功能之间的独特关联，并调整潜在的混杂因素（种族） 、收入、教育、抑郁症和全球认知）。结果显示，每周驾驶天数增加与较高的社会功能存在显着且独立的相关性。了解艾滋病毒感染者驾驶行为背后的因素可能有助于采取干预措施，以促进更好的流动性和改善获得护理的机会。