Developing a Risk Index for Functional Decline in Middle-Aged and Older Adults with HIV

制定中老年艾滋病毒感染者功能衰退的风险指数

• 批准号: 10762280
• 负责人: Lillian Ham
• 金额: $ 4.03万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN DIEGO
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-30 至 2026-09-29
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10762280
• 关键词: Acceleration; Acquired Immunodeficiency Syndrome; Address; Adult; Adverse event; Age; Aging; Behavioral; Biological; Buffers; California; Characteristics; Clinical; Clinical Research; Cognition; Cognitive aging; Communities; Community Practice; Complex; Cross-Sectional Studies; Data; Data Set; Dedications; Development; Development Plans; Diabetes Mellitus; Dimensions; Disease; Elderly; Emotional; Exhibits; Fostering; HIV; HIV Seronegativity; HIV antiretroviral; Hyperlipidemia; Incidence; Individual; Intercept; Intervention Studies; Knowledge; Longitudinal Studies; Maintenance; Measures; Medical; Mental Depression; Mentors; Mentorship; Mission; Modeling; NIH Office of AIDS Research; National Institute on Aging; Neurocognitive Deficit; Outcome; Pattern; Persons; Population; Prevention Research; Prevention strategy; Psychological Factors; Public Health; Research; Research Priority; Risk; Role; Sampling; Scientist; Time; Training; Unemployment; Universities; Validation; Variant; Work; adverse outcome; age effect; aging population; antiretroviral therapy; behavior measurement; biopsychosocial factor; burden of illness; career development; clinical practice; comorbidity; disability; experience; functional decline; functional independence; high risk; human old age (65+); improved; indexing; individualized prevention; longitudinal dataset; middle age; neurobehavioral; novel; peer; predictive modeling; preservation; programs; protective factors; psychologic; research and development; skills; social; tool; tool development

PROJECT SUMMARY/ABSTRACT As people with HIV (PWH) enter older adulthood, there is a growing public health need to preserve everyday functioning in aging PWH. PWH disproportionately experience adverse factors including neurocognitive impairment (NCI) and psychiatric (e.g., depression) and medical (e.g., diabetes) comorbidities relative to age- comparable peers without HIV. Together, these factors put older PWH at risk for everyday functioning decline. Despite this, there are few studies on the longer-term patterns and correlates of everyday functioning change in PWH, and there is no well-validated multivariable risk index informed by such longitudinal data. Therefore, the research aims of this F31 will delineate unique longitudinal trajectories of everyday functioning in PWH; and develop and initially validate a risk index of adverse and protective factors based on longitudinal modeling to identify PWH at risk for functional decline. This project will be conducted with support from an interdisciplinary mentorship team at the University of California, San Diego (UCSD) HIV Neurobehavioral Research Program (HNRP), a leading research center with experts in HIV and aging. The proposed F31 will leverage access to two archival longitudinal studies: CNS HIV Antiretroviral Therapy Effects Research (CHARTER; N = 704) and Multi-Dimensional Successful Aging Among HIV-Infected Adults (N = 106), that were conducted and/or coordinated at the HNRP. Accordingly, the specific aims are to: 1) identify unique everyday functioning trajectories in a development dataset (CHARTER); 2a) develop a prediction model using adverse predictors for functional decline in the development dataset; 2b) validate the model in the development (CHARTER) and validation (Successful Aging) datasets; and 3) determine if positive psychological factors add incremental value to predicting functional decline. The training plan proposes rigorous statistical training in developing advanced longitudinal predictive models of everyday functioning, combined with specific mentoring in the understanding and uses of biopsychosocial variables relevant to aging PWH as potential predictors. This F31 application is in line with the National Institute of Aging’s (NIA) mission to support and conduct biological, clinical, behavioral, and social research on aging; in addition to their mission to foster the development of research and clinician scientists in aging. It is also in line with an NIH Office of AIDS Research (OAR) priority for well-validated, multivariable indices that combine a range of biological to behavioral measures to predict which PWH are at high-risk for adverse outcomes. The opportunities afforded via this F31 mechanism will facilitate the applicant’s professional development toward becoming an independent academic neuropsychologist dedicated to promoting successful aging among older PWH.

项目摘要/摘要 随着艾滋病毒（PWH）的患者进入较早的成年，每天都有越来越多的公共卫生需要保存 在老化的PWH中起作用。 PWH不成比例地体验包括神经认知在内的广告因素 相对于年龄 - 没有艾滋病毒的可比同伴。这些因素在一起，使较旧的PWH处于每天功能下降的危险中。 尽管如此，关于长期模式和日常功能变化的相关性的研究很少 在PWH中，没有通过此类纵向数据告知的验证多变量风险指数。所以， 该F31的研究目的将描述PWH中日常功能的独特纵向轨迹； 基于纵向建模，开发并最初验证不利因素和受保护因素的风险指数 确定有功能下降的风险的PWH。该项目将在 加利福尼亚大学圣地亚哥分校（UCSD）HIV NEUROBEHAVIORAL 研究计划（HNRP）是领先的研究中心，拥有艾滋病毒和衰老专家。拟议的F31将 利用对两项档案纵向研究的访问：中枢神经系统HIV抗逆转录病毒疗法影响研究 （宪章； n = 704）和艾滋病毒感染的成年人（n = 106）的多维成功衰老， 在HNRP进行和/或协调。彼此之间，具体目的是：1）确定独特 开发数据集（Charter）中的日常功能轨迹； 2a）使用 不良预测因素，用于开发数据集的功能下降； 2b）验证模型 开发（章程）和验证（成功的老化）数据集； 3）确定是否为正 心理因素增加了预测功能下降的增量价值。培训计划建议 严格的统计培训在开发每天运作的高级纵向预测模型中 结合与衰老有关的生物心理社会变量的理解和使用中的特定心理 PWH作为潜在预测因子。该F31申请与国家老化研究所（NIA）任务一致 支持和进行有关衰老的生物学，临床，行为和社会研究；除了他们的任务 促进衰老研究和临床科学家的发展。它也与NIH办公室一致 艾滋病研究（OAR）优先级的验证，多变量指数，将一系列生物学结合到 行为措施预测哪些PWH处于广告结果的高风险。机会提供了 通过这种F31机制，将促进申请人的专业发展 独立的学术神经心理学家致力于促进较老的PWH成功衰老。