Executive Cognitive Function of Older People with HIV/AIDS

Kim, Suk-Hee; Miles, Toni P.; Huber, Ruth; Feit, Marvin D.

doi:10.1080/10911350802262879

Cited by 4 publications

(11 citation statements)

References 20 publications

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“…In studies that included a HIV-control group, the proportion of HIV-participants among total samples varied from 20-69% (≥ 50% were controls in 48% of studies). Compared to HIVcontrols, HIV + participants were younger in four studies [43][44][45]50] and older in two studies [29,51]. There were also differences in other demographic factors such as education and ethnicity between HIV + and HIV-participants in 11 studies [40][41][42][43][44][45][50][51][52][53], and they controlled these factors in the analyses.…”

Section: Inclusion Of Hiv-controlsmentioning

confidence: 99%

Is There Any Evidence of Premature, Accentuated and Accelerated Aging Effects on Neurocognition in People Living with HIV? A Systematic Review

et al. 2020

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Despite evidence of premature, accentuated and accelerated aging for some age-related conditions such as cardiovascular diseases in people living with HIV (PLHIV), the evidence for these abnormal patterns of aging on neurocognition remains unclear. Further, no systematic review has been dedicated to this issue. Using PRISMA guidelines, we searched standard databases (PubMed, EMBASE, CINAHL and PsycINFO). Articles were included if they analyzed and reported the effect of age on neurocognition among PLHIV as one of their major findings, if they were conducted in the combination anti-retroviral therapy era (after 1996) and published in a peer-reviewed journal in English. Quality appraisal was conducted using the Joanna Briggs Institute (JBI) appraisal tools. To systematically target the abnormal patterns of neurocognitive aging, we define premature cognitive aging as significant interaction effect of HIV status and age on cross-sectional neurocognitive test performance covering both the normal and abnormal performance range; accentuated cognitive aging as significant interaction effect of HIV status and age on cross-sectional neurocognitive impairment (NCI) rate, thus covering the abnormal performance range only; accelerated cognitive aging as significant interaction effect of HIV status and age on longitudinal neurocognitive test performance or incidence of NCI. Because these definitions require an age-comparable HIV-negative (HIV−) control group, when no controls were included, we determined the range of the age effect on neurocognitive test performance or NCI among PLHIV. A total of 37 studies originating from the US (26), UK (2), Italy (2), Poland (2), China (2), Japan (1), Australia (1), and Brazil (1) were included. Six studies were longitudinal and 14 included HIV- controls. The quality appraisal showed that 12/37 studies neither used an age-matched HIV- controls nor used demographically corrected cognitive scores. A meta-analysis was not possible because study methods and choice of neurocognitive measurement methods and outcomes were heterogeneous imposing a narrative synthesis. In studies with an HIV- control sample, premature neurocognitive aging was found in 45% of the cross-sectional analyses (9/20), while accelerated neurocognitive aging was found in 75% of the longitudinal analyses (3/4). There was no evidence for accentuated aging, but this was tested only in two studies. In studies without an HIV- control sample, the age effect was always present but wide (NCI OR = 1.18–4.8). While large sample size (> 500) was associated with abnormal patterns of cognitive aging, most of the studies were under powered. Other study characteristics such as longitudinal study design and higher proportion of older participants were also associated with the findings of abnormal cognitive aging. There is some support for premature and accelerated cognitive aging among PLHIV in the existing literature especially among large and longitudinal studies and those with higher proportion of older samples. Future HIV and cognitive aging studies need to harmonize neuropsychological measurement methods and outcomes and use a large sample from collaborative multi-sites to generate more robust evidences.

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Section: Inclusion Of Hiv-controlsmentioning

confidence: 99%

Is There Any Evidence of Premature, Accentuated and Accelerated Aging Effects on Neurocognition in People Living with HIV? A Systematic Review

et al. 2020

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“…Understanding of HAND has grown tremendously in the recent years through neuropsychometric research and focus on brain function and impairments [2,9,19]; however, little is known about the subjective experience of living with HIVassociated neurocognitive challenges. A key exception is a study by Gallagher et al [20] that explored the experiences of women with HIV-related neurocognitive disorders.…”

Section: Introductionmentioning

confidence: 99%

“…Moreover, when tested neuropsychologically, people living with HIV perceive that they ''are not ageing as well'' as their HIV-negative counterparts [25]. Here too, however, research approaches have privileged quantitative paradigms, which are best suited for clinical research, [2,9,19] over subjective inquiries into the experience of people again with HIV-associated neurocognitive challenges, which can offer insight into novel directions for practice and research.…”

Section: Introductionmentioning

confidence: 99%

“My body’s a 50 year‐old but my brain is definitely an 85 year‐old”: exploring the experiences of men ageing with HIV‐associated neurocognitive challenges

Hopcroft

Bester

Clément

et al. 2013

Journal of the International AIDS Society

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IntroductionResearch investigating HIV, neurocognition and ageing is well developed using neuropsychometric or other quantitative approaches; however, little is known about individuals’ subjective experiences. The purpose of this article is to explore the experiences of men aged 50 and older who self-identify as having HIV-associated neurocognitive challenges. In particular, this study uses the Episodic Disability Framework (EDF) to explore participants’ perceptions regarding: 1) symptoms/impairments, difficulties with day-to-day activities, challenges with social inclusion and uncertainty; 2) ageing as related to their HIV-associated neurocognitive challenges, and 3) the episodic nature of their HIV-associated neurocognitive challenges.MethodsThis qualitative, interpretive study involved in-depth, semi-structured interviews with 12 men aged 50 years and older who self-identified as having HIV-associated neurocognitive challenges. Participants were recruited from a neurobehavioural research unit (NBRU) at a large hospital in Toronto, Canada. Data were analyzed thematically and with reference to the EDF.ResultsParticipants’ experiences reflected all concepts within the EDF to some extent. Difficulties with daily activities were diverse but were addressed using similar living strategies. Participants described challenges with work and social relationships resulting from neurocognitive challenges. Participants downplayed the significance of uncertainty in their lives, which they attributed to effective living strategies. Most men reported confusion regarding the link between their neurocognitive challenges and ageing. Others discussed ageing as an asset that helped with coping.ConclusionsThis is the first study to use a disability framework to examine the subjective experiences of men ageing with HIV-associated neurocognitive challenges. Findings reframe the episodic disability experienced by these individuals as being predictably linked to certain triggers. As such, support for managing neurocognitive challenges could focus on triggers that exacerbate the condition in addition to the impairments themselves. The study also describes ageing as not only a source of problems but also as an asset among men growing older with HIV.

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“…HIV invades CD4 cells, reproducing within the infected cells, and then bursting out into the bloodstream. The immune S.-h Kim FIGURE 1 Executive cognitive impairment behaviors (Kim, 2008).…”

Section: Definition and Description Of Hiv And Aids Hivmentioning

confidence: 99%

“…Because of the long delay between the time of FIGURE 2 HIV copies and CD4 counts over course of HIV infection (Gilbert, 2003;Kim, 2008).…”

Section: Hiv Positivementioning

confidence: 99%

The Global Security Perspective on the Effects of Executive Cognitive Function on Complex Behavioral Screening Intervention and HIV/AIDS

Kim

2010

Social Work in Public Health

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The purpose of this quantitative study is to understand the global security perspective on the effects of executive cognitive function (ECF) on Complex Behavioral Screening Intervention and HIV/AIDS. The HIV/AIDS pandemic is as much a social, political, economic, and cultural problem as a biomedical one. HIV/AIDS is associated centrally with the collapse not just of communities and families but potentially of states, with some of the largest public health interventions ever and enormous questions about governance, a huge population of orphans, and deep questions about intergenerational relations and cultural transmission. This study also is to develop a screening instrument that improves quality of life for individuals with executive cognitive impairments and behavior problems in our communities and the global society.

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Executive Cognitive Function of Older People with HIV/AIDS

Cited by 4 publications

References 20 publications

Is There Any Evidence of Premature, Accentuated and Accelerated Aging Effects on Neurocognition in People Living with HIV? A Systematic Review

Is There Any Evidence of Premature, Accentuated and Accelerated Aging Effects on Neurocognition in People Living with HIV? A Systematic Review

“My body’s a 50 year‐old but my brain is definitely an 85 year‐old”: exploring the experiences of men ageing with HIV‐associated neurocognitive challenges

The Global Security Perspective on the Effects of Executive Cognitive Function on Complex Behavioral Screening Intervention and HIV/AIDS

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