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Positive Psychological Factors are Linked to Successful Cognitive Aging Among Older Persons Living with HIV/AIDS

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Abstract

We aimed to characterize successful cognitive aging (SCA) among older HIV-infected (HIV+) and HIV-uninfected (HIV−) adults, and to determine associations with positive psychological factors and health-related quality of life (HRQoL). Ninety-nine HIV+ and 46 HIV− older adults (≥ 50 years) completed measures of neurocognition, positive psychological factors, and HRQoL. Using study-defined SCA criteria (i.e., no cognitive or everyday impairment or major depressive disorder), we compared positive psychological factors and HRQoL across four groups: HIV+/SCA+, HIV+/SCA−, HIV−/SCA+, HIV−/SCA−. SCA was identified in 29% of the HIV+ sample compared to 61% of the HIV− sample (p < 0.01). HIV+/SCA+ participants had higher scores on 8 of 10 measures of positive psychological factors as well as better HRQoL (ps < 0.05) as compared to the HIV+/SCA− group. Furthermore, the HIV+/SCA+ participants had comparable scores on these factors as HIV− adults. Fewer HIV+ than HIV− participants met SCA criteria; however, the level of positive psychological factors among the HIV+/SCA+ group was comparable to the HIV− sample. Our findings present opportunities for interventions to optimize positive psychological factors and potentially improve SCA among older HIV+ adults.

Resumen

Nuestro objetivo fue caracterizar el envejecimiento cognitivo exitoso (ECE) entre personas mayores VIH+ y VIH−, y determinar asociaciones con factores psicológicos positivos y con la calidad de vida relacionada a la salud (CVrS). Noventa y nueve personas mayores (de 50 años o más) VIH+ y 46 VIH− completaron indicadores de neurocognición, de factores psicológicos positivos y de CVrS. Mediante la utilización de criterios de ECE definidos por el presente estudio (p. ej. la ausencia de deterioro cognitivo, impedimentos en el funcionamiento cotidiano, o trastorno depresivo mayor) comparamos los factores psicológicos positivos y la CVrS entre cuatro grupos: VIH+/ECE+, VIH+/ECE−, VIH−/ECE+, VIH−/ECE−. El ECE fue identificado en 29% de la muestra de VIH+ comparado con 61% de la muestra de VIH− (p < 0,01). Los participantes VIH+/ECE+ obtuvieron puntuaciones más altas en 8 de los 10 indicadores de factores psicológicos positivos, así como mejor CVrS (ps < 0,05), comparado con el grupo VIH+/ECE−. Además, los participantes VIH+/ECE+ obtuvieron valores comparables a los de los adultos VIH− en estos factores. Una proporción menor de participantes VIH+ que VIH− cumplieron criterios de ECE; sin embargo, el nivel de los factores psicológicos positivos en el grupo VIH+/ECE+ fue comparable a la muestra de la población VIH−. Nuestros resultados presentan oportunidades de intervención para optimizar los factores psicológicos positivos y potencialmente mejorar el ECE entre los adultos mayores con VIH.

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Acknowledgments

The San Diego HIV Neurobehavioral Research Program [HNRP] group is affiliated with the University of California, San Diego, the Naval Hospital, San Diego, and the Veterans Affairs San Diego Healthcare System, and includes: Director: Robert K. Heaton, Ph.D., Co-Director: Igor Grant, M.D.; Associate Directors: J. Hampton Atkinson, M.D., Ronald J. Ellis, M.D., Ph.D., and Scott Letendre, M.D.; Center Manager: Thomas D. Marcotte, Ph.D.; Jennifer Marquie-Beck, M.P.H.; Melanie Sherman; Neuromedical Component: Ronald J. Ellis, M.D., Ph.D. (P.I.), Scott Letendre, M.D., J. Allen McCutchan, M.D., Brookie Best, Pharm.D., Rachel Schrier, Ph.D., Debra Rosario, M.P.H.; Neurobehavioral Component: Robert K. Heaton, Ph.D. (P.I.), J. Hampton Atkinson, M.D., Steven Paul Woods, Psy.D., Thomas D. Marcotte, Ph.D., Mariana Cherner, Ph.D., David J. Moore, Ph.D., Matthew Dawson; Neuroimaging Component: Christine Fennema-Notestine, Ph.D. (P.I.), Monte S. Buchsbaum, M.D., John Hesselink, M.D., Sarah L. Archibald, M.A., Gregory Brown, Ph.D., Richard Buxton, Ph.D., Anders Dale, Ph.D., Thomas Liu, Ph.D.; Neurobiology Component: Eliezer Masliah, M.D. (P.I.), Cristian Achim, M.D., Ph.D.; Neurovirology Component: David M. Smith, M.D. (P.I.), Douglas Richman, M.D.; International Component: J. Allen McCutchan, M.D., (P.I.), Mariana Cherner, Ph.D.; Developmental Component: Cristian Achim, M.D., Ph.D.; (P.I.), Stuart Lipton, M.D., Ph.D.; Participant Accrual and Retention Unit: J. Hampton Atkinson, M.D. (P.I.), Jennifer Marquie-Beck, M.P.H.; Data Management and Information Systems Unit: Anthony C. Gamst, Ph.D. (P.I.), Clint Cushman; Statistics Unit: Ian Abramson, Ph.D. (P.I.), Florin Vaida, Ph.D. (Co-PI), Reena Deutsch, Ph.D., Anya Umlauf, M.S. The views expressed in this article are those of the authors and do not reflect the official policy or position of the Department of the Navy, Department of Defense, nor the United States Government.

Funding

This work was primarily supported by ID10-SD-057 from California HIV/AIDS Research Program (CHRP) (D.J. Moore, PI) and the University of California San Diego (UCSD) Stein Institute for Research on Aging Faculty Pilot Research Grant (D.J. Moore, PI). Additional support was provided by the following National Institutes of Health (NIH) Grants: R01MH099987 (D.J. Moore & D.V. Jeste, MPI), P30MH062512 (R.K. Heaton, PI), R00 AG048762 (P.L. Fazeli, PI), K23 MH107260 (R.C. Moore, PI).

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Authors and Affiliations

  1. Department of Psychiatry, University of California, San Diego, San Diego, CA, USA

    David J. Moore, Pariya L. Fazeli, Raeanne C. Moore, Steven P. Woods, Dilip V. Jeste & Igor Grant

  2. Department of Family, Community, and Health Systems, School of Nursing, University of Alabama at Birmingham, Birmingham, AL, USA

    Pariya L. Fazeli

  3. Stein Institute for Research on Aging, University of California, San Diego, San Diego, CA, USA

    Raeanne C. Moore & Dilip V. Jeste

  4. Veterans Administration San Diego Health Care System, San Diego, San Diego, CA, USA

    Raeanne C. Moore

  5. Department of Psychology, University of Houston, Houston, TX, USA

    Steven P. Woods

  6. Department of Medicine, University of California, San Diego, San Diego, CA, USA

    Scott L. Letendre

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  1. David J. Moore
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  2. Pariya L. Fazeli
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Consortia

the HIV Neurobehavioral Research Program

  • Robert K. Heaton
  • , Igor Grant
  • , J. Hampton Atkinson
  • , Ronald J. Ellis
  • , Scott Letendre
  • , Thomas D. Marcotte
  • , Jennifer Marquie-Beck
  • , Melanie Sherman
  • , J. Allen McCutchan
  • , Brookie Best
  • , Rachel Schrier
  • , Debra Rosario
  • , Steven Paul Woods
  • , Mariana Cherner
  • , David J. Moore
  • , Matthew Dawson
  • , Christine Fennema-Notestine
  • , Monte S. Buchsbaum
  • , John Hesselink
  • , Sarah L. Archibald
  • , Gregory Brown
  • , Richard Buxton
  • , Anders Dale
  • , Thomas Liu
  • , Eliezer Masliah
  • , Cristian Achim
  • , David M. Smith
  • , Douglas Richman
  • , Stuart Lipton
  • , Anthony C. Gamst
  • , Clint Cushman
  • , Ian Abramson
  • , Florin Vaida
  • , Reena Deutsch
  •  & Anya Umlauf

Corresponding author

Correspondence to David J. Moore.

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Moore, D.J., Fazeli, P.L., Moore, R.C. et al. Positive Psychological Factors are Linked to Successful Cognitive Aging Among Older Persons Living with HIV/AIDS. AIDS Behav 22, 1551–1561 (2018). https://doi.org/10.1007/s10461-017-2001-5

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