2014
DOI: 10.1097/jnn.0000000000000074
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The Synergistic Effects of HIV, Diabetes, and Aging on Cognition

Abstract: In addition to the obvious health problems and/or physical limitations associated with HIV, diabetes, and aging, each of these are known to independently affect cognitive functioning. While this relationship to cognition does not necessarily mean frank cognitive impairments are inevitable with HIV, diabetes, and aging, it does entail that each of these conditions may lead to poorer cognitive performance compared to younger adults and individuals without HIV and diabetes. Many individuals may be aware of the ph… Show more

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Cited by 32 publications
(19 citation statements)
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“…58 In addition, studies in uninfected adults show that with advancing age, women perceive more stress than men. 59 Such stress may lead to metabolic disorders such as insulin resistance and diabetes.…”
Section: Discussionmentioning
confidence: 99%
“…58 In addition, studies in uninfected adults show that with advancing age, women perceive more stress than men. 59 Such stress may lead to metabolic disorders such as insulin resistance and diabetes.…”
Section: Discussionmentioning
confidence: 99%
“…PLHIV are living longer and accumulating NCDs, resulting in multimorbidity, defined as two or more chronic NCDs . In PLHIV , NCDs have been associated with decreased quality of life and physical function, dementia and mortality .…”
Section: Introductionmentioning
confidence: 99%
“…More specifically, a greater medical comorbidity burden (mostly for diabetes and malignancy), assessed by the Charlson Comorbidity Index [ 79 ], in older HIV-infected adults was associated with global NCI and related functional declines and lower physical health-related quality of life [ 12 ]. Other data in older HIV-infected adults are supportive of this finding—reporting that these individuals develop metabolic dysfunction (and other comorbidities) disorders leading to type 2 diabetes and NCI, through depleting cognitive reserve, that can impair everyday functioning and reduce quality of life [ 80 ]. In line with these findings, changes in VACS Index scores, which is a composite marker of HIV disease severity, including age, HIV-related factors (current plasma HIV RNA load and CD4 cell counts) and “non-HIV-associated biomarkers” (indicators of renal and hepatic function, anemia, and HCV co-infection), correspond to longitudinal changes in neurocognitive function among middle/aged HIV-infected individuals [ 81 ].…”
Section: Phenotypic Inter-relationships: Comorbid Aging/hiv and Cognimentioning
confidence: 87%
“…Other possibilities for the adverse impact of HIV-associated mental health comorbidities on cognition include (1) competing for cognitive resources through rumination (i.e., depressive or suicidal thoughts that prevent other thoughts from emerging), (2) displaying different cognitive profiles (e.g., executive dysfunction is common in schizophrenia), and (3) a convergence of compromising vascular effects (diabetes mellitus, hypertension, and HIV infection). Related to these possibilities, models have been proposed for the synergistic effects of HIV, type 2 diabetes, and aging on cognition [ 80 ]. To further elucidate the role of each of these mechanisms would require separating out components and domains of the cognitive phenotype.…”
Section: Phenotypic Inter-relationships: Comorbid Aging/hiv and Cognimentioning
confidence: 99%