Longitudinal Trajectories of Physical and Cognitive Function among Persons Aging with HIV

项目摘要和摘要 老年艾滋病毒携带者(PWH)认知损害率高，并在 与普通人群相比，它的功能更强。这些功能状态的下降与 威斯康星病的发病率和死亡率很高。在一般y人口中的老年人中，纵向 体能和认知功能之间的动态关系已经被确定。在PWH中，横截面 认知受损和身体功能之间的联系以前已经被注意到了，但纵向的 认知功能和身体功能的轨迹以及它们之间的关系还没有得到评估。二甲双胍有 显示出作为感官裂解剂的前景。目前正在进行临床试验，以研究二甲双胍在预防 在没有感染艾滋病毒的老年成年人中，与年龄相关的发病率下降。这项提案将调查纵向的 慢性阻塞性肺疾病患者认知功能与身体功能的关系及二甲双胍应用的潜在影响 在这些轨迹上。拟议研究将利用来自三个大型前瞻性、观察性研究的数据 艾滋病毒携带者或有感染风险的男性和女性队列。这项调查将是第一次全面审查 大量PWH患者认知功能和身体功能的纵向关联及其影响评估 二甲双胍治疗对PWH患者预后的影响。我们的发现将为我们提供关注的重点和理想的时机 干预措施，如使用二甲双胍预防认知和体力障碍的正式介入临床试验 老年威斯康星患者的功能下降。此外，这项提议与GEMSSTAR计划的使命一致 支持一位寻求在老龄化和艾滋病毒研究之间架起桥梁的年轻研究人员，以改善对老年威斯康星医院的护理。

PROJECT SUMMARY AND ABSTRACT Older persons with HIV (PWH) experience high rates of cognitive impairment and accelerated declines in function compared to the general population. These functional status declines have been associated with significant morbidity and mortality in among PWH. Among the elderly in the general y population, longitudinal dynamic relationships between physical and cognitive function have been identified. In PWH, cross-sectional associations between impaired cognition and physical function have been previously noted, but longitudinal trajectories of cognitive and physical function and how they are related have not been evaluated. Metformin has shown promise as a senolytic agent. Clinical trials are underway to investigate use of metformin in preventing age-related declines in among elderly adults without HIV. This proposal will investigate the longitudinal relationship between cognitive and physical function in PWH and assess the potential impact of metformin use on these trajectories. The proposed study will utilize data available from three large prospective, observational cohorts of men and women with or at risk for HIV. This investigation will be the first to comprehensively examine longitudinal associations between cognitive and physical function in a large group of PWH and assess the impact of metformin therapy on these outcomes among PWH. Our findings will inform the focus and ideal timing of interventions such as a formal interventional clinical trial of metformin use to prevent cognitive and physical function declines among older PWH. Moreover, this proposal aligns with the GEMSSTAR program’s mission to support a young investigator seeking to bridge aging and HIV research to improve care for older PWH.