Although highly-active anti-retroviral therapy (HAART) successfully reduces viral load in HIV and dramatically increases life expectancy, HIV-infected (HIV-positive) patients are at higher risk for chronic progressive medical conditions including HIV-associated dementia. Since HIV-positive patients tend to develop these conditions sooner than HIV-uninfected (HIV-negative) individuals, it has been hypothesized that the presence of the HIV virus accelerates end-organ senescence. Little is known, however, about premature brain senescence in HIV. Magnetic resonance imaging (MRI) has demonstrated structural brain abnormalities in older individuals without overt disease and in HIV-positive persons, even before frank cognitive and motor impairments emerge. However, the combined effects of the virus and age on the macro- and micro-structural characteristics of the brain have not been investigated. Chronic inflammation is thought to be a major contributor to age- and HIV-related structural brain changes. However, the role of inflammation in the combined effects of HIV and age on the macro- and micro-structure of the brain remains understudied. Further, although African Americans represent the largest proportion of those infected with HIV, and are at higher risk for chronic medical conditions associated with inflammation, few studies have directly compared racial differences in HIV-related brain abnormalities. Thus, the overall goal of this project is to investigate the combined effects of HIV, age and race on brain structure, to determine the role of inflammation in these effects, and to study the association of inflammation-related brain abnormalities in HIV to cognitive and motor impairments.

Public Health Relevance

Reducing age and race-related health disparities in HIV research, and discovering brain biomarkers for early identification of persons at risk for adverse cognitive and motor outcomes in HIV, are high public health priorities. This study addresses both priorities by examining the combined effects of age and race on inflammation-related brain abnormalities in HIV, and associations with cognitive and motor function.

National Institute of Health (NIH)
National Institute on Minority Health and Health Disparities (NIMHD)
Exploratory Grants (P20)
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Special Emphasis Panel (ZMD1-RN)
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Rush University Medical Center
United States
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Turner, Arlener D; Capuano, Ana W; Wilson, Robert S et al. (2015) Depressive symptoms and cognitive decline in older african americans: two scales and their factors. Am J Geriatr Psychiatry 23:568-78
Barnes, Lisa L; Bennett, David A (2014) Alzheimer's disease in African Americans: risk factors and challenges for the future. Health Aff (Millwood) 33:580-6
Rajan, Kumar B; Wilson, Robert S; Skarupski, Kimberly A et al. (2014) Gene-behavior interaction of depressive symptoms and the apolipoprotein E {varepsilon}4 allele on cognitive decline. Psychosom Med 76:101-8
Fleischman, Debra A; Leurgans, Sue; Arfanakis, Konstantinos et al. (2014) Gray-matter macrostructure in cognitively healthy older persons: associations with age and cognition. Brain Struct Funct 219:2029-49
Tangney, Christy C; Li, Hong; Wang, Yamin et al. (2014) Relation of DASH- and Mediterranean-like dietary patterns to cognitive decline in older persons. Neurology 83:1410-6
James, Bryan D; Leurgans, Sue E; Hebert, Liesi E et al. (2014) Contribution of Alzheimer disease to mortality in the United States. Neurology 82:1045-50
Arfanakis, Konstantinos; Fleischman, Debra A; Grisot, Giorgia et al. (2013) Systemic inflammation in non-demented elderly human subjects: brain microstructure and cognition. PLoS One 8:e73107