The High-Intensity Exercise to Attenuate Limitations and Train Habits (HEALTH) in Older Adults with HIV

项目摘要 随着治疗和护理的进步，更长的预期寿命正在改变艾滋病毒感染者的人口统计学特征。 在美国，近一半的艾滋病毒感染者现在已经50岁或以上。艾滋病毒感染者， 即使在接受有效的艾滋病毒药物治疗的同时，与艾滋病毒相比， 未感染的人群。年龄增长、共病负担和生活方式因素，导致大于 老年人日常功能的关键组成部分预期受损，疲劳负担重 艾滋病毒携带者需要有效的、可扩展的、非药物策略来改善老年人的健康寿命。 这个弱势群体。 这项建议的总体目标是确定高强度间歇训练（HIIT）是否可以 克服1）身体功能障碍和增加的疲劳和2）线粒体损伤 生物能量学的老年人与艾滋病毒（PWH）在更大程度上比持续中等强度的运动 （CME）。我们进一步寻求确定HIIT或HIIT后的生物行为教练干预是否 CME可以促进长期坚持身体活动，这是可持续发展的重要组成部分。 干预我们之前已经证明了身体功能的损害大于预期， 老年艾滋病毒感染者中疲劳的发病率很高。我们发现CME和抗阻运动可以改善 老年威尔斯亲王医院的身体功能，从更高强度的有氧运动和 阻力训练计划此外，只有我们的高强度持续有氧运动干预， 减少PWH的疲劳。最后，只有不到一半的参与者至少坚持锻炼一次。 这表明，即使锻炼有益， 威尔斯亲王医院难以维持。总之，我们的研究结果表明，一种创新的锻炼方法是 需要改善身体机能，减少疲劳，并保持长期的运动习惯， 老威尔斯亲王医院 为了满足这一关键需求，我们提出的研究将利用两个不同参与者的资源， 人口在科罗拉多大学和凯斯西储大学1）比较HIIT与CME 2）比较HIIT与CME对骨骼肌和外周血的影响 单核细胞线粒体生物能量学，和3）测试教练干预与控制身体 活动的坚持，评估这些方法的看法，使用混合的方法。这项研究将产生 关于身体功能和对运动的疲劳反应的严格数据，相关的线粒体适应， 并研究灌输持续自我导向运动行为的策略。总的来说，我们的发现将为我们提供信息， 针对高龄威尔斯亲王医院的独特需要，制定可扩展的、有效的运动建议。

PROJECT ABSTRACT With advances in treatment and care,a longer life expectancy is changing the demographics of the HIV epidemic, and nearly half of those living with HIV in the U.S. are now 50 years or older. People living with HIV, even while receiving effective HIV medications, have excess morbidity and mortality compared to HIV- uninfected populations. Increasing age, comorbid burden, and lifestyle factors, contribute to greater than expected impairments in key components of daily function and a high burden of fatigue among older adults living with HIV. Effective, scalable, non-pharmacological strategies are needed to improve the healthspan of this vulnerable population. The overall goals of this proposal are to determine whether high-intensity interval training (HIIT) can overcome 1) physical function impairments and increased fatigue and 2) impairments in mitochondrial bioenergetics of older people with HIV (PWH) to a greater extent than continuous moderate-intensity exercise (CME). We further seek to determine whether a biobehavioral coaching intervention following either HIIT or CME can promote long-term adherence to physical activity, a crucial component of the sustainability of the intervention. We have previously demonstrated greater than expected impairments in physical function and a high prevalence of fatigue among older adults with HIV. We found that CME and resistance exercise improves physical function in older PWH, with additional improvements from a higher-intensity aerobic and resistance exercise program. Additionally, only our higher-intensity continuous aerobic exercise intervention reduced fatigue among PWH. Lastly, less than half of our participants continued to exercise at least once a week following the supervised intervention, which suggests that even when exercise is beneficial it can be difficult for PWH to maintain. Together, our findings suggest that an innovative approach to exercise is needed to improve physical function, reduce fatigue, and to maintain a long-term exercise habit among older PWH. To address this critical need, our proposed study will leverage the resources of two diverse participant populations at the University of Colorado and Case Western Reserve University to 1) Compare HIIT vs CME on physical function and fatigue, 2) Compare HIIT vs CME on skeletal muscle and peripheral blood mononuclear cell mitochondrial bioenergetics, and 3) Test a coaching intervention vs control on physical activity adherence, assessing perceptions of these approaches using mixed methods. This study will generate rigorous data on physical function and fatigue responses to exercise, the associated mitochondrial adaptations, and investigate strategies to instill sustained, self-directed exercise behavior. Overall, our findings will inform the development of scalable, effective exercise recommendations tailored to the unique needs of aging PWH.