Effects of anxiety on neurocognitive performance positive adults living in Lusaka

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Ncheka, Msumba Joyce
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Anxiety has been associated with poor treatment compliance, disease progression, increased use of the health care services and it has been found to take up cognitive capacity leaving less attentional resources for a number of tasks leading to poor cognitive performance. On the other hand, it has been consistently demonstrated that HIV has increased risk for neuropsychological dysfunction in later stages of the infection. However, mixed results have been obtained in previous studies, some studies have shown these relationships whilst others have not (Airaksinen, 2006). Therefore, the aim of the study was to examine the effects of anxiety on neuropsychological performance among HIV positive adults.Methods: A cross-sectional study was carried out to investigate the effects of HIV related anxiety on neurocognitive performance in adults living in Lusaka Province. A sample of 263 participants was recruited, comprising 107 (40.7%) males and 156 (59.3%) females. There were 150 participants (57%) with no anxiety, 60 (22.8%) showed mild anxiety, 27 (10.3%) moderate and 26 (9.9) had severe anxiety. The participants’ ages ranged between 21 and 65 years.All the participants were conversant with the English language, and their level of education was between 5 and 20 years of schooling. Nurses identified the HIV positive prospective participants who upon giving informed consent to taking part in the study, were evaluated on their cognitive functioning and anxiety levels using the International Neurobehavioural Test Battery and Beck Anxiety Inventory respectively.Results: Severe anxiety results obtained using the Beck Anxiety Inventory and cognitive functioning as measured by the International Neurobehavioural Test Battery, showed a weak positive correlation (r=.148), indicating that high levels of anxiety are associated with poor cognitive performance. A standard multiple regression was conducted on anxiety, age, World Health Organisation staging and CD4 count to determine the cognitive deficits associated with cognitive performance.Anxiety did not reach statistical significance on any of the cognitive domains.However, age reached statistical significance on the learning (B=.116, SE=.058,β=.338, p=.011), verbal fluency (B=.162, SE=.063, β=.118, p=.010) and recalldomain (B=.161, SE=.062, β=.146, p=.010). The other variable that reached statistical significance was CD4 count on Speed of information processing (SIP) domain (B=.004, SE= .002, β= .188, p= .037) and the global mean (B=.004,SE=.002, β=.188, p=.007). A logistic regression analysis was conducted to investigate the impact of anxiety and cognitive performance on instrumental activities of daily living (IADL) status. Out of 205 participants included in this analysis, 188 were IADL independent and 17 were IADL dependent. Anxiety reached statistical significance on all the seven domains assessed (p<005) indicating that participants who were IADL dependent were more likely to be anxious than the ones who were IADL independent. Gender effects were seen on the global mean, executive functioning and SIP domains, indicating that males and females differed in performance on these domains. Conclusion: Results obtained from this study seem to imply that in general there are minimal differences in performance between non anxious and anxious participants, though, a weak positive correlation between severe anxiety and neurocognitive performance was seen. This is not a significant result and cannot be generalized as the sample size for severe anxiety was small (n= 26). The study revealed that those who were IADL dependent were more likely to be anxious.
HIV/AIDS(Disease)-Complications , Cognitive Disorders