Studies on cognitive performance among older people living with HIV in eastern Europe and central Asia: a scoping review

Background Despite the growth of the population of older people living with HIV (PLWH), data on cognitive disorders among older PLWH, particularly in low- and middle-income countries, are scarce. These data are especially underrepresented in the literature from eastern Europe and central Asia (EECA). Objectives This scoping review aimed to describe the peer-reviewed literature on cognitive health among PLWH in the EECA region. Eligibility criteria We selected articles from peer-reviewed journals that reported on cognitive assessments or the prevalence and characteristics of cognitive disorders among adult (≥18 years) PLWH in EECA countries (Armenia, Azerbaijan, Belarus, Estonia, Georgia, Kazakhstan, Kyrgyzstan, Latvia, Lithuania, Moldova, Russia, Tajikistan, Turkmenistan, Ukraine and Uzbekistan). Studies assessing cognition among PLWH related to traumatic brain injury, brain tumours, COVID-19, meningitis, neurosyphilis and/or other central nervous system infections were excluded. Source of evidence We searched for relevant data published up to March 2025 using four online databases (PubMed, CINAHL, Web of Science and PsycINFO). Charting methods Covidence, a web-based collaborative software platform, was used for data screening and extraction. Two independent reviewers screened abstracts and full texts, resolving disagreements through consensus. The data were extracted based on the predefined data extraction criteria. Results A total of 1388 peer-reviewed articles were identified; 295 articles were removed due to duplication; and 1053 and 25 articles were excluded based on the abstract/title and full-text screenings, respectively. Finally, 15 articles met the inclusion criteria. All 15 studies used different neuropsychological assessments to measure cognitive performance by domain and/or cognitive disorders among various subgroups of PLWH. One cross-sectional study focused on older populations (≥40 years old), using standardised cognitive performance assessment tests. However, it neither provided information about the prevalence estimate of cognitive disorders nor identified risk factors. Conclusion Existing literature on cognitive disorders among older PLWH in the EECA region is limited and insufficient to estimate prevalence, or identify risk factors, and ultimately develop appropriate policy addressing the needs of older PLWH in this region. This scoping review underscores the urgent need for large-scale, longitudinal studies employing standardised, culturally adapted neuropsychological batteries and adherence to rigorous reporting standards.