Management of older ( 50 years old) HIV-infected individuals is becoming increasingly complex as many develop multiple HIV-associated-non-AIDS-defining (HANA) comorbidities at an earlier onset. We will utilize frailty measurements and neuropsychological performance (NP) tests to determine if a combination of cognitive impairment and frailty identifies vulnerable older HIV-infected individuals (n=130). In addition, we will employ innovative brain imaging techniques [including arterial spin labeling magnetic resonance imaging (ASL-MRI) and positron emission tomography using Pittsburgh B compound (PET-PiB)] to quantitatively assess perfusion and amyloid deposition in older HIV-infected individuals. We will evaluate if frailty correlates with neuroimaging biomarkers (ASL and PET-PIB) of brain integrity in older HIV-infected patients. Finally, we will determine at three year follow-up if frail older HIV-infected individuals have greater rates of change from baseline in cognitive impairment (NP testing), amyloid deposition (PET-PiB), and perfusion (ASL-MRI) compared to pre-frail or non-frail older HIV-infected individuals. This proposal will place HIV associated changes in frailty and cognition into the mainstream of national brain aging research. We will develop biomarkers that will allow for early detection of changes in brain function at the pre-frail state. It is hoped that these biomarkers will assist in the early administration of tailoed effective interventions.

Public Health Relevance

Contemporary care of older (? 50 years old) HIV-infected patients has become complex and is characterized by the early onset of HIV associated non-AIDS (HANA) conditions. This proposal will: 1) increase our knowledge concerning the interaction between frailty and neuropsychological performance in older HIV-infected individuals; 2) assess the relationship between frailty and neuroimaging markers of amyloid deposition and cerebral blood. These results could assist practitioners in developing early interventions at the pre-frail state to prevent or delay subsequent transition to frailty in older IV-infected individuals.

Agency
National Institute of Health (NIH)
Institute
National Institute of Nursing Research (NINR)
Type
Research Project (R01)
Project #
5R01NR014449-05
Application #
9232007
Study Section
Special Emphasis Panel (ZRG1-AARR-K (58)R)
Program Officer
Henry, Rebecca
Project Start
2013-05-13
Project End
2018-02-28
Budget Start
2017-03-01
Budget End
2018-02-28
Support Year
5
Fiscal Year
2017
Total Cost
$454,514
Indirect Cost
$139,863
Name
Washington University
Department
Neurology
Type
Schools of Medicine
DUNS #
068552207
City
Saint Louis
State
MO
Country
United States
Zip Code
63130
Cooley, Sarah A; Paul, Robert H; Fennema-Notestine, Christine et al. (2016) Apolipoprotein E ε4 genotype status is not associated with neuroimaging outcomes in a large cohort of HIV+ individuals. J Neurovirol 22:607-614
Guha, Anika; Brier, Matthew R; Ortega, Mario et al. (2016) Topographies of Cortical and Subcortical Volume Loss in HIV and Aging in the cART Era. J Acquir Immune Defic Syndr 73:374-383
Behrman-Lay, Ashley M; Paul, Robert H; Heaps-Woodruff, Jodi et al. (2016) Human immunodeficiency virus has similar effects on brain volumetrics and cognition in males and females. J Neurovirol 22:93-103
Wright, Patrick W; Pyakurel, Ashmit; Vaida, Florin F et al. (2016) Putamen volume and its clinical and neurological correlates in primary HIV infection. AIDS 30:1789-94
Ances, Beau M; Hoare, Jacqueline (2016) Perinatal HIV in the brain: Mission incomplete despite combination antiretroviral therapy. Neurology 86:13-4
Guha, Anika; Wang, Liang; Tanenbaum, Aaron et al. (2016) Intrinsic network connectivity abnormalities in HIV-infected individuals over age 60. J Neurovirol 22:80-7
Ortega, Mario; Brier, Matthew R; Ances, Beau M (2015) Effects of HIV and combination antiretroviral therapy on cortico-striatal functional connectivity. AIDS 29:703-12
Ortega, Mario; Baker, Laurie M; Vaida, Florin et al. (2015) Physical Activity Affects Brain Integrity in HIV+ Individuals. J Int Neuropsychol Soc 21:880-9
Thomas, Jewell B; Brier, Matthew R; Ortega, Mario et al. (2015) Weighted brain networks in disease: centrality and entropy in human immunodeficiency virus and aging. Neurobiol Aging 36:401-12
Brouillette, Marie-J; Mayo, Nancy; Fellows, Lesley K et al. (2015) A better screening tool for HIV-associated neurocognitive disorders: is it what clinicians need? AIDS 29:895-902

Showing the most recent 10 out of 32 publications