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 i nclude (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.

Agency
National Institute of Health (NIH)
Institute
National Institute of Mental Health (NIMH)
Type
Small Research Grants (R03)
Project #
5R03MH076642-02
Application #
7614992
Study Section
Behavioral and Social Consequences of HIV/AIDS Study Section (BSCH)
Program Officer
Stoff, David M
Project Start
2008-04-17
Project End
2011-03-31
Budget Start
2009-04-01
Budget End
2011-03-31
Support Year
2
Fiscal Year
2009
Total Cost
$72,500
Indirect Cost
Name
University of Alabama Birmingham
Department
Other Health Professions
Type
Schools of Nursing
DUNS #
063690705
City
Birmingham
State
AL
Country
United States
Zip Code
35294
Vance, David E; Jensen, Michael; Tende, Frida et al. (2018) Individualized-Targeted Computerized Cognitive Training to Treat HIV-Associated Neurocognitive Disorder: An Interim Descriptive Analysis. J Assoc Nurses AIDS Care 29:604-611
Fazeli, Pariya L; Crowe, Michael; Ross, Lesley A et al. (2014) Cognitive Functioning in Adults Aging with HIV: A Cross-Sectional Analysis of Cognitive Subtypes and Influential Factors. J Clin Res HIV AIDS Prev 1:155-169
Vance, David E; Fazeli, Pariya L; Grant, Joan S et al. (2013) The role of neuroplasticity and cognitive reserve in aging with HIV: recommendations for cognitive protection and rehabilitation. J Neurosci Nurs 45:306-16
Vance, David E; Fazeli, Pariya L; Gakumo, C Ann (2013) The impact of neuropsychological performance on everyday functioning between older and younger adults with and without HIV. J Assoc Nurses AIDS Care 24:112-25
Vance, David E; Fazeli, Pariya L; Moneyham, Linda et al. (2013) Assessing and treating forgetfulness and cognitive problems in adults with HIV. J Assoc Nurses AIDS Care 24:S40-60
Vance, David E; Fazeli, Pariya L; Ross, Lesley A et al. (2012) Speed of processing training with middle-age and older adults with HIV: a pilot study. J Assoc Nurses AIDS Care 23:500-10
Vance, David E (2010) Aging with HIV: clinical considerations for an emerging population. Am J Nurs 110:42-7; quiz 48-9