Cognitive Health, Psychosocial factors, and behaviors relevant to aging successfully with HIV

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PROJECT SUMMARY/ABSTRACT Advancements in therapy have drastically improved life expectancy for people living with HIV and many individuals are living well into older adulthood. Older adults living with HIV, defined as those who are 50 years and older, make up almost half of all individuals living with HIV in the US. Although life expectancy has increased, older adults living with HIV have greater risk for multiple physical, mental, and psychosocial health burdens compared to uninfected older adults. It is well documented that people living with HIV are at increased risk for impaired cognition, including cognitive impairment leading to dementia and Alzheimer’s Disease, and HIV associated neurocognitive disorders (HAND). The consequences of cognitive impairment among this population have far reaching implications for population and public health. Impaired individuals may lose the ability to fully engage in activities involved in HIV care, such as adherence to antiretroviral therapies. Impaired individuals may also lose the ability to fully engage in other health promoting and beneficial behaviors such as participate in physical and leisure activities, and activate or utilize positive resources like social support, purpose in life, and financial resources. Taken within a broader life course context, having multiple life stressors may also negatively impact the ability to engage in health behaviors and resources and influence cognitive outcomes. However, research has yet to disentangle the impact of cognition on engagement in healthy behaviors within the context of positive resource utilization in older adults with HIV. A greater understanding of this is needed given the aging of the population living with HIV and the corresponding public health burden. The overall goals of the proposed Career Development Award (K01) goals are to investigate the relationship between cognitive deficits and health promoting behaviors, clarify the moderating role of positive resources, and to determine the cumulative impact of these interactions on quality of life for older adults experiencing stress while living with HIV. This will be achieved through the completion of the proposed training plan, organized under the four content domains of cognition, HIV and aging, biostatistics and longitudinal research design, and professional development. This training plan was designed with the goal of launching the PI’s career as an independent investigator with a research program focused on the interplay of cognition, psychosocial factors, and life stress on health and successful aging in individuals aging with HIV.