Chronicity of HIV and Aging on Neuropsychological and Everyday Performance

描述(由申请人提供)：高效抗逆转录病毒疗法(HAART)降低了艾滋病毒相关死亡率，帮助患有这种疾病的人变老。根据疾病控制和预防中心的数据，50岁及以上的成年人感染艾滋病毒/艾滋病的人数从2001年的65,655例增加到2004年的104,260例，预计这一数字将随着人口的普遍老龄化而增加。鉴于艾滋病毒和老龄化对认知的协同影响，感染艾滋病毒的长期影响可能会导致认知能力下降，影响日常功能和生活质量，导致心理健康状况变差和自主性降低。这项研究计划包括一项横断面研究，旨在确定年龄和病程(慢性病)如何影响这一不断增长的人口的认知和日常功能。具体目标包括(1)检查感染和不感染艾滋病毒的老年人和年轻人在认知方面的差异，(2)检查处理速度的障碍如何与日常功能有关，以及(3)检查疾病慢性病和衰老如何影响认知和日常功能。这些目标将通过比较120名感染和未感染艾滋病毒的老年人和年轻人在一些测试中的表现来实现，这些测试衡量不同认知领域的功能(例如，记忆、处理速度)和日常功能(例如，IADL)。具体地说，这项研究的目标是加工速度，因为它是其他认知能力的认知资源(例如，加工理论的速度减慢)，以及它与日常功能的关系。这项研究将产生设计临床认知干预所需的数据。这种认知干预可能会改善艾滋病毒感染者的认知健康、日常功能、活力和生活质量。阿拉巴马大学伯明翰分校的爱德华·R·罗伊巴尔衰老和活动翻译研究中心已经开发并测试了许多认知干预措施，包括处理速度训练(一种认知补救疗法)，用于没有感染艾滋病毒的社区老年人。已经发现，处理训练的速度可以改善这一领域的认知表现，以及在实验室测量日常功能方面的表现。如果在感染艾滋病毒的成年人中观察到与年轻的艾滋病毒携带者或年龄较大的未感染艾滋病毒的人相比，处理缺陷的速度如此之快，那么处理速度的培训在艾滋病毒老年患者中可能是合理和有效的。 与公共卫生相关的高效抗逆转录病毒疗法(HAART)正在促进艾滋病毒携带者的衰老，延长神经元暴露于艾滋病毒的持续时间。然而，年龄和艾滋病毒对认知的交互作用，如处理速度和日常功能，需要进行检查，以确定可能出现的陷阱。该应用程序建议检查这一现象，并提供一种可能的干预措施，以应对处理速度对这一新兴群体的日常功能产生不利影响。

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.