Emerging directions of cognitive aging with HIV: practice and policy implications for social work

Vance, David E.; Lee, Yookyong; Batey, D. Scott; Li, Wei; Lambert, Crystal Chapman; Nakkina, Sai Rashmi; Anderson, Joseph N; Triebel, Kristen; Byun, Jun Y; Fazeli, Pariya L

doi:10.1080/01634372.2021.1978028

Cited by 6 publications

(11 citation statements)

References 45 publications

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“…The vulnerability of PLHIV to cognitive impairment is demonstrated in Figure 1. 17,55,78 HIV related factors…”

Section: Aetiologies For Neurocognitive Impairment In Older Plhivmentioning

confidence: 99%

“…42 Age-associated co-morbidities, namely visual and hearing impairment, neurodegenerative diseases, falls with traumatic brain injury kidney disease, cerebrovascular disease, coronary heart disease (CHD), and Multifactorial aetiologies for neurocognitive impairment in PLHIV. 17,55,78 their risk factors may compromise normal cognitive functioning. 30,32,43 CHD and its vascular risk factors also predisposes PLHIV to cognitive impairment via systemic atherosclerosis and cerebral hypo-perfusion, due to impaired cardiac function or infarcts from cardiogenic emboli to the brain.…”

Section: Cognitive Ageing With Hivmentioning

confidence: 99%

“…Medichec informs clinicians on the choice of medicines and any changes which may result in cognitive impairment in older people, along with the size of the effect for different medicines individually and in combination. 17,52 Substance use and mental health disorder Substance use (including nicotine, alcohol, cocaine, and amphetamines) and mental health disorders like depression, anxiety and psychosis are common among older PLHIV, who face significant stigma, fear of rejection by family and friends, disease and death, financial insecurity, and dependence. 53,54 As these disorders affect cognitive functioning, and increase non-adherence to medication and suicide rates, they should be addressed and treated early to achieve recovery or at least remission.…”

Section: Polypharmacymentioning

confidence: 99%

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An overview of neurocognitive impairment in older people living with HIV

Yip

Teh

2023

Proceedings of Singapore Healthcare

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Background With improved survival among People Living with HIV (PLHIV), many are confronted with age associated comorbidities and geriatric syndromes. Neurocognitive impairment is one of the three most frequent conditions that affects quality of life of PLHIV despite achieving viral suppression. Healthcare providers face challenges in early identification of neurocognitive impairment, performing comprehensive assessment and managing older PLHIV. Objectives This paper aims to review available evidence regarding aetiology and management of older PLHIV who develop neurocognitive impairment, suggest improvements on current management and postulate future study direction. Methods A PubMed search for original articles and Clinical Guidelines was conducted from September 2021 to August 2022 using a combination of keywords related to neurocognitive impairment in PLHIV. The citations from all selected articles were reviewed for additional studies. Results Older PLHIV tend to be frailer than their uninfected counterparts, are plagued with multi-morbidity and are at increased risk of cognitive impairment. The aetiologies for neurocognitive impairment are multifactorial, multi-dimensional and complex. The management of neurocognitive impairment in older PLHIV involves identifying and optimizing predisposing factors, physical function, social and psychological health with appropriate care navigation. Conclusion Identification and management of neurocognitive impairment in older PLHIV through interdisciplinary collaboration among stakeholders is important. This exemplifies an integrated model of care for older PLHIV and promotes the notion of living well beyond viral suppression.

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“…The vulnerability of PLHIV to cognitive impairment is demonstrated in Figure 1. 17,55,78 HIV related factors…”

Section: Aetiologies For Neurocognitive Impairment In Older Plhivmentioning

confidence: 99%

Section: Cognitive Ageing With Hivmentioning

confidence: 99%

Section: Polypharmacymentioning

confidence: 99%

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An overview of neurocognitive impairment in older people living with HIV

Yip

Teh

2023

Proceedings of Singapore Healthcare

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“…Addressing strategies to protect and promote cognitive health in older PWH, including those caregivers with HIV, should also be a focus. Vance et al (in press) provided several areas in which to address cognitive vulnerability in older PWH; these include: (a) cART adherence to maintain viral control, (b) treatment of comorbidities such as diabetes and heart disease to avoid the negative impact on brain health and cognition, (c) treatment of neuro-comorbidities such as depression, (d) treatment of substance misuse to mitigate their impact on brain health and cognition, (e) mindfulness approaches to reduce stress, (f) cognitive training to support existing cognitive functioning, and (g) general health promotion (i.e., sleep, physical activity).…”

Section: Implications For Clinical Practice and Researchmentioning

confidence: 99%

Risk Factors of Cognitive Decline in Older Caregivers With HIV: An Emerging Hypothesis

Vance¹,

Lee²,

Batey³

et al. 2022

J Assoc Nurses AIDS Care

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People with HIV (PWH) are living longer and healthier lives; thanks to combination antiretroviral therapy. As many PWH age, they find themselves providing care to family members and friends, just as their counterparts without HIV. The literature indicates that becoming a caregiver creates conditions that compromise one's cognitive function. Additionally, nearly 45% of all PWH experience HIV-associated neurocognitive disorder and are already vulnerable to cognitive impairment due to HIV, aging, and accompanying health conditions, and lifestyle factors. Given what is known, we assert that caregivers with HIV, especially as they age, are at additional risk for developing cognitive impairments. The purpose of this commentary was to briefly examine the juxtaposition between cognitive vulnerability of caregiving and the cognitive vulnerability of aging with HIV. Potential factors contributing to impaired cognition include stress, lack of social support, stigma, lifestyle, and comorbidities. Implications for clinical practice and research are provided.

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“…Social work, as a regulated health profession with expertise in mindfulness and cognitive training models and on the frontlines of psychosocial geriatric support and care, may also contain the ideal facilitators of such interventions (Wong et al, 2017b). However, there is a literature gap regarding the implementation factors of these interventions (Birnbaum & Birnbaum, 2008) and their possible combination for social workers to support the intersecting cognitive and aging needs of older adults (Vance et al, 2022).…”

Section: Introductionmentioning

confidence: 99%

Mindfulness and cognitive training interventions that address intersecting cognitive and aging needs of older adults

Eaton,

Rourke,

Craig

et al. 2023

Journal of Social Work

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Summary Mindfulness and cognitive training interventions are promising models to address impacts (e.g., anxiety and stress) of cognitive impairment among older adults. Combining strategies may yield better outcomes than models offered in isolation. However, there are numerous uncertainties about these interventions, potential for combination, and implementation. Social workers are well placed to offer these interventions. Findings From an initial search of 3,538 records, 13 studies were included in the final review. Mindfulness studies focused on stress reduction or cognitive behavioral therapy. Cognitive training studies applied stimulation or activity approaches. Results indicate that the field is still emerging, as most studies were pilot or feasibility trials. A combination of mindfulness-based stress reduction and brain training activities may offer the most promising model for older adults with cognitive impairment, based on outcome assessments and other factors. A common limitation among the reports was detailed on engaging older adults with cognitive challenges in the design and implementation of these interventions. Applications This realist review deepens the understanding of how, why, for whom, and in what circumstances a combination of mindfulness and cognitive training could be most successful for social workers to address intersecting cognitive and aging needs of older adults. Building evidence on combining mindfulness-based stress reduction and brain training activities among older adults with cognitive impairment could yield promising results, and this review identifies implementation considerations. The review also found a need for psychometric scale development on the benefits of brain training activities.

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Emerging directions of cognitive aging with HIV: practice and policy implications for social work

Cited by 6 publications

References 45 publications

An overview of neurocognitive impairment in older people living with HIV

An overview of neurocognitive impairment in older people living with HIV

Risk Factors of Cognitive Decline in Older Caregivers With HIV: An Emerging Hypothesis

Mindfulness and cognitive training interventions that address intersecting cognitive and aging needs of older adults

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