A longitudinal analysis of methamphetamine use, social relationships, and cognitive function among people living with HIV

项目总结/摘要 有令人信服但缺乏证据表明，越来越常见的艾滋病毒，甲基苯丙胺， 使用（MU）和衰老形成了破坏认知功能的有害三重奏。HIV和MU都是风险 神经认知功能下降的因素和证据表明，艾滋病毒感染后继续使用物质（SU） 感染可能会损害认知功能。据估计，超过70%的艾滋病毒感染者（PWH） 在未来十年中，年龄>50岁和年龄较大的PWH经历终身SU和 认知障碍我们对SU，HIV和认知功能之间相互交织的关系的理解存在差距。 在生物年龄和时间上发挥作用。随着时间的推移和年龄的变化，检查认知变化将有所帮助 确定潜在的干预点，以维持整个生命过程中的大脑健康。减少MU的干预措施 和支持大脑健康的老年PWH是至关重要的，改善社会关系是一个有前途的领域， 干预通过应用先进的统计建模方法和利用一个特殊的分析 一组527名成年人（18-87岁）和使用冰毒的人，这项研究是独一无二的。 定位于严格推进对这些跨年龄交织关系的科学理解， 在感染和未感染艾滋病毒的成年人中。本研究的具体目的是：1）评估有效性， 可靠性 在美国国立卫生研究院情绪测试中， 艾滋病毒，为目标2和3的分析提供信息; 2)检查a）我们样本中不同年龄的认知障碍， 确定a） 在HIV感染者和非HIV感染者中，随着时间的推移，MU和认知功能之间的相互关联，以及B） 研究社会关系在多大程度上介导了MU和认知之间的纵向关联 在感染和未感染艾滋病毒的成年人中发挥作用。 B）不同年龄段的HIV状态、MU和社会关系的认知功能变化;以及3） 拟议的K 01也将为我提供丰富的机会， 成为NIH资助的生命历程研究的领导者，应用先进的定量和定性方法 进行高影响力，严格的NIH资助的关于PWH的心理社会需求与共同发生的SU和 其他精神和身体健康共病的寿命：（1）加深我的专业知识， （2）扩大我对SU和认知功能的认识， 测量可能介导HIV、SU和认知功能关系的社会关系因素; (3)获得时变效应建模的专业知识;（4）发展我在纵向结构方面的专业知识 方程建模，包括交叉滞后面板分析，以检查随时间的相互变化。本研究 导师团队获得的结果和技能 从这个奖项将导致科学出版物 这些研究提供了对MU、认知功能和社会关系之间交织关系的深入了解， 威尔斯亲王医院的寿命，以及为介入发展提供方向。 培训将在国家认可的 确保我作为一个独立的NIH资助的科学家的成功;

PROJECT SUMMARY/ABSTRACT There is compelling but scant evidence that the increasingly common combination of HIV, methamphetamine use (MU), and aging form a deleterious trio that undermines cognitive functioning. HIV and MU are both risk factors for decreased neurocognitive function and evidence shows that continued substance use (SU) after HIV infection may erode cognitive functioning. Estimates indicate that over 70% of people living with HIV (PWH) will be >50 years of age in the next decade and older PWH experience a high burden of both lifetime SU and cognitive impairment. A gap exists in our understanding of the intertwining relationships of SU, HIV, and cognitive function across biological ages and over time. Examining cognitive change over time and across ages will help identify potential points of intervention to maintain brain health across the life course. Interventions to reduce MU and support brain health among aging PWH are vital and improving social relationships is a promising area of intervention. By applying advanced statistical modeling methods and capitalizing on an exceptional analytic cohort of 527 adults with and without HIV (ages 18-87) and people who use meth, the proposed study is uniquely positioned to rigorously advance scientific understanding of these intertwining relationships across ages and over time among adults with and without HIV. The specific aims of this study are to 1) Assess the validity and reliability of the social relationship measures in the NIH Toolbox Emotions Battery in adults aging with vs. without HIV, to inform Aims 2 and 3 analyses; 2) Examine a) age-varying cognitive impairment among our sample, and Identify a) the reciprocal associations between MU and cognitive function over time among people with and without HIV and b) examine the extent to which social relationships mediate the longitudinal associations between MU and cognitive function among adults with and without HIV. b) variations in cognitive function across age by HIV status, MU, and social relationships; and 3) The proposed K01 will also provide me with a rich opportunity to become an NIH-funded leader in life course research who applies advanced quantitative and qualitative methods to conduct high impact, rigorous NIH-funded about the psychosocial needs of PWH with co-occurring SU and other mental and physical health comorbidities across the lifespan by: (1) deepening my expertise in the substantive content and measurement of SU and cognitive function; (2) expanding my knowledge about the measurement of social relationship factors that might mediate relationships of HIV, SU, and cognitive function; (3) gaining expertise in time-varying effect modeling; and (4) developing my expertise in longitudinal structural equation modeling, including cross-lagged panel analysis, to examine reciprocal change over time. This research team of mentors. The findings and skills obtained from this award will result in scientific publications that provide insight into the intertwining relationships of MU, cognitive function, and social relationships across the life span among PWH; and provide direction for intervention development. and training will be conducted under a nationally recognized ensure my success as an independent NIH-funded scientist;