Impact of HIV and aging on neuropsychological function

Wendelken, Lauren A.; Valcour, Victor

doi:10.1007/s13365-012-0094-1

Cited by 91 publications

(71 citation statements)

References 52 publications

(68 reference statements)

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“…Therefore, the impact of APOEε4 and alterations in the processing of amyloid and synuclein or neurodegeneration in older HIV-infected individuals is still a matter of debate and needs to be clarified by further studies. 65–67 …”

Section: Biomarkers Of Neurodegenerative Diseasesmentioning

confidence: 99%

HIV and Aging: Effects on the Central Nervous System

2014

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With the introduction of combination antiretroviral therapy, many human immunodeficiency virus-positive (HIV+) individuals are reaching advanced age. The proportion of people living with HIV older than 50 years already exceeds 50% in many communities, and is expected to reach this level nationally by 2015. HIV and aging are independently associated with neuropathological changes, but their concurrence may have a more deleterious effect on the central nervous system (CNS). Published data about neurocognitive and neuroimaging markers of HIV and aging are reviewed. Putative factors contributing to neurocognitive impairment and neuroimaging changes in the aging HIV+ brain, such as metabolic disturbances, cardiovascular risk factors, immune senescence, and neuroinflammation, are described. The possible relationship between HIV and some markers of Alzheimer’s disease is presented. Current research findings emphasize multiple mechanisms related to HIV and combination antiretroviral therapy that compromise CNS structure and function with advancing age.

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Section: Biomarkers Of Neurodegenerative Diseasesmentioning

confidence: 99%

HIV and Aging: Effects on the Central Nervous System

2014

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“…Mounting evidence suggests that advanced age is among these risk factors (Cherner et al, 2004; Cohen & Gongvatana, 2010; Harezlak et al, 2011; van Gorp et al, 1994; Vance, 2006; Wendelken & Valcour, 2012; Wilkie et al, 2003). The odds of having HAND are as much as 3 times greater in people with HIV over the age of 50 years (Becker, Lopez, Dew, & Aizenstein, 2004; Valcour et al, 2004).…”

Section: Introductionmentioning

confidence: 99%

Verbal memory declines more rapidly with age in HIV infected versus uninfected adults

Seider

Luo

Gongvatana

et al. 2014

Journal of Clinical and Experimental Neuropsychology

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Objectives In the current era of effective antiretroviral treatment, the number of older adults living with HIV is rapidly increasing. This study investigated the combined influence of age and HIV infection on longitudinal changes in verbal and visuospatial learning and memory. Methods In this longitudinal, case-control design, 54 HIV seropositive and 30 seronegative individuals aged 40–74 received neurocognitive assessments at baseline visits and again one year later. Assessment included tests of verbal and visuospatial learning and memory. Linear regression was used to predict baseline performance and longitudinal change on each test using HIV serostatus, age, and their interaction as predictors. MANOVA was used to assess the effects of these predictors on overall baseline performance and overall longitudinal change. Results The interaction of HIV and age significantly predicted longitudinal change in verbal memory performance, as did HIV status, indicating that although the seropositive group declined more than the seronegative group overall, the rate of decline depended on age such that greater age was associated with a greater decline in this group. The regression models for visuospatial learning and memory were significant at baseline, but did not predict change over time. HIV status significantly predicted overall baseline performance and overall longitudinal change. Conclusions This is the first longitudinal study focused on the effects of age and HIV on memory. Findings suggest that age and HIV interact to produce larger declines in verbal memory over time. Further research is needed to gain a greater understanding of the effects of HIV on the aging brain.

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“…6,7,[31][32][33][34] Similarities have led some to observe that the neurocognitive effects of HIV are actually quite similar to the changes in cognition associated with the normal aging process. 33 Older adults are also at an increased risk for vascular disorders and degenerative disease, as well as immunological changes and expression of apolipoprotein E4 (APOE4), all of which may have a negative impact neurocognitive functioning. 8,35 This is especially relevant for HIV-seropositive older adults, as comorbidities are common in this population.…”

Section: Discussionmentioning

confidence: 99%

“…Specifically, a number of studies show that older HIV-seropositive individuals tend to perform more poorly across multiple neurocognitive domains (eg, learning, memory, executive functions, motor speed) than their younger HIV-seropositive counterparts and be at increased risk for meeting criteria for HAND. 6,7,[31][32][33][34] Similarities have led some to observe that the neurocognitive effects of HIV are actually quite similar to the changes in cognition associated with the normal aging process. 33 Older adults are also at an increased risk for vascular disorders and degenerative disease, as well as immunological changes and expression of apolipoprotein E4 (APOE4), all of which may have a negative impact neurocognitive functioning.…”

mentioning

confidence: 99%

Aging and HIV/AIDS: Neurocognitive Implications for Older HIV-Positive Latina/o Adults

Mindt¹

2013

PsycEXTRA Dataset

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In recent years, HIV/AIDS populations have become older and increasingly more ethnically diverse. Concurrently, the prevalence of HIV-related neurocognitive (NC) impairment remains high. This study examined the effects of age and ethnicity on NC function in HIV-positive adults. The sample (N = 126; 84 Latina/o and 42 Non-Hispanic White) completed a comprehensive NC battery. Global NC and domain average demographically-corrected t-scores were generated. There were no significant differences between Younger (<50 years) Latina/os and non-Hispanic Whites on Global NC function or NC domains (all p's >.10), with generally small effect sizes. Older Latina/os (≥50 years) were significantly more impaired than Older Non-Hispanic Whites on Correspondence should be addressed to Monica Rivera Mindt, PhD, ABPP-CN, Fordham University, Department of Psychology-DE 322, New York, NY 10024, USA. riveramindt@fordham.edu. 2009. 3,4 Estimates suggest that these trends will continue, 4 and will contribute to the "graying of HIV." HHS Public AccessDespite advancements in treatment, recent research indicates that the prevalence of HIVassociated neurocognitive disorders (HAND) continue to remain as high as 52%, similar to rates reported in the pre-cART era. 5 Emerging evidence further suggests that older PLWH may be at even higher risk for developing HAND, although this literature remains somewhat equivocal (Cherner et al., 2004;Valcour, 2004). 6,7 A number of factors may potentially confer increased risk of neurocognitive decline in older PLWH, including increased risk for cardiovascular and cerebrovascular pathology, immunological changes, and expression of apolipoprotein E4 (APOE4), among others. 8 However, the potential interactions of aging and HIV disease remain poorly understood. 8The risk factors for neurocognitive decline are especially salient for older racial/ethnic minority PLWHA, and this remains an understudied and poorly understood area. Not only has the HIV/AIDS population become older overall, but this population has also become increasingly ethnically diverse. In the US, the Latina/o population is disproportionately impacted by the HIV/AIDS epidemic. Among people 50 years or older in the US, Latina/os are five times as likely as their white counterparts to be living with HIV, 3 and once infected, the HIV-seropositive Latina/o population carries greater disease burden compared to nonHispanic white adults. 9 For instance, HIV-seropositive Latina/o adults have a higher mortality rate, are more likely to die at significantly younger ages, and demonstrate significantly worse executive functioning (even after accounting for relevant covariates such as reading level which is a proxy for quality of education) compared to their non-Hispanic White counterparts. 10,11,12,13 The general US Latina/o population also suffers from myriad other health disparities, including higher rates of stroke, diabetes, obesity, and hypertension. 10,14,15 Within an aging, HIV-seropositive, and ethnically diverse urban cohort similar to tha...

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Impact of HIV and aging on neuropsychological function

Cited by 91 publications

References 52 publications

HIV and Aging: Effects on the Central Nervous System

HIV and Aging: Effects on the Central Nervous System

Verbal memory declines more rapidly with age in HIV infected versus uninfected adults

Aging and HIV/AIDS: Neurocognitive Implications for Older HIV-Positive Latina/o Adults

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