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

HIV 感染者的甲基苯丙胺使用、社会关系和认知功能的纵向分析

• 批准号: 10663991
• 负责人: Alexis Anne Bender
• 金额: $ 18.01万
• 依托单位: EMORY UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-30 至 2025-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10663991
• 关键词: Acquired Immunodeficiency Syndrome; Address; Adolescence; Adult; Age; Age Years; Aging; Area; Award; Biological; California; Caring; Data; Data Set; Drug Addiction; Drug usage; Elderly; Emotions; Ensure; Equation; Family; Funding; Future; HIV; HIV Infections; Impaired cognition; Individual; Intervention; Investments; Knowledge; Life Cycle Stages; Longevity; Longitudinal Studies; Measurement; Measures; Mediating; Mental Health; Mentors; Methamphetamine; Methamphetamine use disorder; Methods; Modeling; Multivariate Analysis; National Institute of Drug Abuse; National Institute of Mental Health; Neurocognitive; Neurocognitive Deficit; Older Population; Pathway interactions; Persons; Positioning Attribute; Principal Investigator; Publications; Qualitative Methods; Research; Risk Factors; Sampling; Scientific Advances and Accomplishments; Scientist; Social support; Societies; Statistical Methods; Statistical Models; Strategic Planning; Substance Use Disorder; Time; Training; United States National Institutes of Health; Universities; Validity and Reliability; Variant; Vulnerable Populations; brain health; co-infection; cognitive change; cognitive function; cohort; comorbidity; experience; improved; innovation; insight; longitudinal analysis; longitudinal database; methamphetamine use; neurobehavioral; novel; peer; physical conditioning; population health; psychosocial; reduced substance use; skills; social relationships; substance use; success; therapy design; therapy development; treatment response; young adult

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;

项目摘要/摘要 有令人信服但几乎没有证据表明艾滋病毒、甲基苯丙胺越来越常见的组合 使用(MU)和衰老形成了有害的三重奏，破坏了认知功能。HIV和MU都是危险的 神经认知功能下降的因素和证据表明艾滋病毒后的持续物质使用(SU) 感染可能会侵蚀认知功能。估计超过70%的艾滋病毒携带者(PWH)将 下一个十年50岁及以上的威尔斯亲王都将经历一生的沉重负担和 认知障碍。我们对SU、HIV和认知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。研究认知随时间和年龄的变化将有所帮助 确定潜在的干预点，以在整个生命过程中保持大脑健康。减少MU的干预措施 和支持老年PWH的大脑健康是至关重要的，改善社会关系是一个有希望的领域 干预。通过应用先进的统计建模方法并利用特殊的分析 对527名感染和不感染艾滋病毒的成年人(18-87岁)和吸食冰毒的人进行了队列研究，这项研究是独一无二的 定位于严格推进对这些跨越年龄和年龄的相互交织的关系的科学理解 随着时间的推移，艾滋病毒携带者和非艾滋病毒携带者中的成年人。这项研究的具体目的是：1)评估效度和 可靠性 美国国立卫生研究院工具箱情绪成套测验中的社会关系测量在有无变老的成年人中的比较 艾滋病毒，告知目标2和3的分析； 2)在我们的样本中检验a)年龄变化的认知障碍，以及 确定a) 艾滋病毒携带者和非HIV携带者和非HIV携带者MU与认知功能之间的相互关系 考察社会关系在多大程度上调节MU和认知之间的纵向联系 在感染和不感染艾滋病毒的成年人中发挥作用。 B)不同年龄的认知功能因艾滋病毒状况、MU和社会关系的差异； 拟议的K01也将为我提供一个丰富的机会 成为美国国立卫生研究院资助的生命历程研究领域的领导者，应用先进的定量和定性方法 对威斯康星医院的心理社会需求进行高影响力、严谨的NIH资助，同时进行SU和SU 其他一生中的心理和身体健康合并症：(1)加深我在 SU和认知功能的实质性内容和测量；(2)扩大我对SU的认识 测量可能调节HIV、SU和认知功能关系的社会关系因素； (3)获得时变效果建模方面的专业知识；及(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，以检验随时间的互惠变化。这项研究 导师团队。所获得的发现和技能 这一奖项将导致科学出版物的出版 提供了对MU、认知功能和社会关系的相互交织关系的洞察 威尔斯亲王的寿命；并为干预发展提供方向。 培训将在国家认可的 确保我作为美国国立卫生研究院资助的独立科学家取得成功；