Chronicity of HIV and Aging on Neuropsychological and Everyday Performance

点击翻译按钮获取中文摘要

DESCRIPTION (provided by applicant): Highly Active Antiretroviral Therapy (HAART) has decreased HIV-related mortality, helping people aging with this disease. According to the Centers for Disease Control and Prevention, the number of adults with HIV/AIDS 50 years and older rose from 65,655 cases in 2001 to 104,260 cases in 2004, and this number is expected to increase along with the aging of the population in general. Given the synergistic effects of HIV and aging on cognition, the long term effects of having HIV may produce cognitive declines that impact everyday functioning and quality of life, resulting in poorer mental health and decreased autonomy. This research program consists of a cross-sectional study designed to determine how age and disease duration (chronicity) impact cognition and everyday function in this growing population. Specific aims include (1) examining differences in cognition between older and younger adults with and without HIV, (2) examining how impairments in speed of processing relate to everyday function, and (3) examining how disease chronicity and aging influence cognition and everyday function. These aims will be achieved by comparing the performance of 120 older and younger adults with and without HIV on a number of tests that measure functioning in different cognitive domains (e.g., memory, speed of processing) and everyday functioning (e.g., IADLs). Specifically, this study targets speed of processing given its implications as a cognitive resource for other cognitive abilities (e.g., diminished speed of processing theory) and its relationship to everyday functioning. This study will generate data necessary to design a clinical cognitive intervention. Such cognitive interventions may improve cognitive health, everyday functioning, vitality, and quality of life in adults aging with HIV. Many cognitive interventions, including speed of processing training (a cognitive remediation therapy), have already been developed and tested at the University of Alabama at Birmingham's Edward R. Roybal Center for Translational Research in Aging and Mobility for use in community-dwelling older adults who do not have HIV. Speed of processing training has been found to improve cognitive performance in this domain, as well as performance on laboratory measures of everyday functioning. If such speed of processing deficits are observed in adults with HIV compared to those younger with HIV or those older without HIV, speed of processing training may be warranted and efficacious in adults aging with HIV. PUBLIC HEALTH RELEVANCE Highly Active Antiretroviral Therapy (HAART) is facilitating aging with HIV, extending the duration in which neurons are being exposed to HIV. Yet, the interaction of age and HIV on cognition such as speed of processing and everyday functioning needs to be examined to determine what pitfalls may occur. This application proposes to examine this phenomenon and provides a possible intervention should speed of processing detrimentally impacts everyday functioning in this emerging population.