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Jones R, Jessee MB, Booker R, Martin SL, Vance DE, Fazeli PL. Associations Between Estimates of Arterial Stiffness and Cognitive Functioning in Adults With HIV. J Acquir Immune Defic Syndr 2024; 95:456-462. [PMID: 38133605 PMCID: PMC10951550 DOI: 10.1097/qai.0000000000003374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 12/07/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND Vascular aging, a precursor of arterial stiffness, is associated with neurocognitive impairment (NCI) and cardiovascular disease. Although HIV is associated with rapid vascular aging, it is unknown whether arterial stiffness mediates changes in cognitive function. We explored whether estimated markers of vascular aging were associated with NCI indices in HIV-positive individuals. METHODS This study was a secondary analysis of an observational study. Neurocognitive functioning was assessed using a battery of 7 domains (verbal fluency, executive functioning, speed of information processing, attention/working memory, memory [learning and delayed recall], and motor skills). Vascular aging was assessed using estimated markers of arterial stiffness (ie, estimated pulse wave velocity, pulse pressure, and vascular overload index). A multivariable regression adjusted for demographics, cardiovascular disease risk factors, and HIV clinical variables was used to examine the association between vascular aging and NCI outcomes. RESULTS Among 165 people with HIV, the mean age was 51.5 ± 6.9 years (62% men and 83% African American/Black or Other). In fully adjusted models, an increase in estimated pulse wave velocity and pulse pressure was associated with lower T scores in learning (-2.95 [-5.13, -0.77]) and working memory (-2.37 [-4.36, -0.37]), respectively. An increase in vascular overload index was associated with lower T scores in working memory (-2.33 [-4.37, -0.29]) and learning (-1.85 [-3.49, -0.21]). CONCLUSIONS Estimated markers of arterial stiffness were weakly associated with neurocognitive functioning, suggesting that vascular aging may have a role in cognitive decline among people with HIV.
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Affiliation(s)
- Raymond Jones
- Department of Medicine, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL
- Center for Exercise Medicine, University of Alabama at Birmingham, Birmingham, AL
| | - Matthew B. Jessee
- Department of Health, Exercise Science, and Recreation Management, University of Mississippi, University, MS
| | - Robert Booker
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Samantha L. Martin
- Department of Obstetrics and Gynecology, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL
| | - David E. Vance
- Department of Family, Community, and Health Systems, School of Nursing, University of Alabama at Birmingham, Birmingham, AL
| | - Pariya L. Fazeli
- Department of Family, Community, and Health Systems, School of Nursing, University of Alabama at Birmingham, Birmingham, AL
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Quach LT, Ritchie CS, Reynolds Z, Paul R, Seeley J, Tong Y, Hoeppner S, Okello S, Nakasujja N, Olivieri-Mui B, Saylor D, Greene M, Asiimwe S, Tindimwebwa E, Atwiine F, Sentongo R, Siedner MJ, Tsai AC. HIV, Social Networks, and Loneliness among Older Adults in Uganda. AIDS Behav 2024; 28:695-704. [PMID: 38281251 PMCID: PMC10947585 DOI: 10.1007/s10461-023-04258-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/26/2023] [Indexed: 01/30/2024]
Abstract
Loneliness among older adults has been identified as a major public health problem. Yet little is known about loneliness, or the potential role of social networks in explaining loneliness, among older people with HIV (PWH) in sub-Saharan Africa, where 70% of PWH reside. To explore this issue, we analyzed data from 599 participants enrolled in the Quality of Life and Ageing with HIV in Rural Uganda study, including older adults with HIV in ambulatory care and a comparator group of people without HIV of similar age and gender. The 3-item UCLA Loneliness Scale was used to measure loneliness, and HIV status was the primary explanatory variable. The study found no statistically significant correlation between loneliness and HIV status. However, individuals with HIV had smaller households, less physical and financial support, and were less socially integrated compared to those without HIV. In multivariable logistic regressions, loneliness was more likely among individuals who lived alone (aOR:3.38, 95% CI:1.47-7.76) and less likely among those who were married (aOR:0.34, 95% CI:0.22-0.53) and had a higher level of social integration (aOR:0.86, 95% CI: 0.79-0.92). Despite having smaller social networks and less support, older adults with HIV had similar levels of loneliness as those without HIV, which may be attributed to resiliency and access to HIV-related health services among individuals with HIV. Nonetheless, further research is necessary to better understand the mechanisms involved.
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Affiliation(s)
- Lien T Quach
- Medical Practice Evaluation Center, Mongan Institute, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA.
- Centre for Aging and Serious Illness, Mongan Institute, Massachusetts General Hospital, Boston, MA, USA.
- Division of Palliative Care and Geriatric Medicine, Department of Medicine, Massachusetts General Hospital, Boston, USA.
- Department of Gerontology, University of Massachusetts Boston, Boston, MA, USA.
- Harvard Medical School, Boston, MA, USA.
- The Massachusetts Veterans Epidemiology Research and Information Center, VA Boston Healthcare System, Boston, USA.
| | - Christine S Ritchie
- Centre for Aging and Serious Illness, Mongan Institute, Massachusetts General Hospital, Boston, MA, USA
- Division of Palliative Care and Geriatric Medicine, Department of Medicine, Massachusetts General Hospital, Boston, USA
- Harvard Medical School, Boston, MA, USA
| | - Zahra Reynolds
- Medical Practice Evaluation Center, Mongan Institute, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Robert Paul
- Department of Psychological Sciences, University of Missouri at St. Louis, St. Louis, USA
| | - Janet Seeley
- Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, UK
| | - Yao Tong
- Medical Practice Evaluation Center, Mongan Institute, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Susanne Hoeppner
- Harvard Medical School, Boston, MA, USA
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Samson Okello
- Mbarara University of Science and Technology, Mbarara, Uganda
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Noeline Nakasujja
- Department of Psychiatry, College of Health Sciences, Makerere University School of Medicine, Kampala, Uganda
| | - Brianne Olivieri-Mui
- Department of Health Sciences, Bouvé College of Health Sciences, Northeastern University, Boston, MA, USA
| | - Deanna Saylor
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Meredith Greene
- Department of Medicine, Indiana University School of Medicine and Indiana University Center for Aging Research, Regenstreif Institute, Inc., Indianapolis, IN, USA
| | - Stephen Asiimwe
- Medical Practice Evaluation Center, Mongan Institute, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA
- Mbarara University of Science and Technology, Mbarara, Uganda
- Kabwohe Clinical Research Center, Kabwohe, Uganda
| | | | - Flavia Atwiine
- Mbarara University of Science and Technology, Mbarara, Uganda
| | - Ruth Sentongo
- Mbarara University of Science and Technology, Mbarara, Uganda
| | - Mark J Siedner
- Medical Practice Evaluation Center, Mongan Institute, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
- Mbarara University of Science and Technology, Mbarara, Uganda
| | - Alexander C Tsai
- Harvard Medical School, Boston, MA, USA
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- Mbarara University of Science and Technology, Mbarara, Uganda
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Ng RQM, Yip KF, Teh YE. An overview of neurocognitive impairment in older people living with HIV. PROCEEDINGS OF SINGAPORE HEALTHCARE 2023. [DOI: 10.1177/20101058231160605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/27/2023] Open
Abstract
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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Affiliation(s)
- Rachel QM Ng
- Department of Geriatric Medicine, Singapore General Hospital, Singapore, Singapore
| | - KF Yip
- Department of Geriatric Medicine, Singapore General Hospital, Singapore, Singapore
| | - YE Teh
- Department of Infectious Disease, Singapore General Hospital, Singapore, Singapore
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Haase SR, Billings R, Vance DE, Fazeli PL. The Association Between Intrapersonal Resilience Resources and Quality of Life Among Older Persons Living With HIV: A Systematic Review. J Assoc Nurses AIDS Care 2023; 34:502-526. [PMID: 37815846 PMCID: PMC10593503 DOI: 10.1097/jnc.0000000000000432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/11/2023]
Abstract
ABSTRACT Despite positive improvements in health care, older persons living with HIV (PWH) still face psychosocial challenges and medical issues that affect their overall quality of life (QoL). Intrapersonal resilience resources may serve as a protective factor allowing PWH to better cope with adversity, thereby improving their well-being. In our systematic review, we examined intrapersonal resilience resources and their association with QoL outcomes among middle-aged and older PWH (≥40 years). Four databases (CINAHL, PubMed, PsycINFO, and Embase) were searched, and 1,400 articles were yielded. Following screening and full-text review, 19 studies met full criteria and were included. Based on our findings from these studies, trait resilience, spirituality, and self-efficacy were the most common resilience resources investigated. Resilience resources were positively associated with QoL outcomes and mediated the association between various psychosocial factors (e.g., stigma) and QoL. Future studies should explore resilience resources and QoL over time among diverse populations of PWH.
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Affiliation(s)
- Shakaye R. Haase
- Department of Psychology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Rebecca Billings
- UAB Libraries, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - David E. Vance
- School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Pariya L. Fazeli
- School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
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5
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Saez-Sanz N, Peralta-Ramirez I, Gonzalez-Perez R, Vazquez-Justo E, Caracuel A. Resilience, Stress, and Cortisol Predict Cognitive Performance in Older Adults. Healthcare (Basel) 2023; 11:healthcare11081072. [PMID: 37107906 PMCID: PMC10137485 DOI: 10.3390/healthcare11081072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 04/05/2023] [Accepted: 04/07/2023] [Indexed: 04/29/2023] Open
Abstract
OBJECTIVE to determine the relationship between stress, resilience, and cognitive performance in older people without dementia. METHOD multiple linear regressions were performed using measures of cognitive performance as dependent variables, and measures of stress and resilience as predictors in a sample of 63 Spanish elderly people. RESULTS participants reported low levels of stress during their lifetime. In addition to socio-demographic variables, greater stress was related to better delayed recall and worse letter-number sequencing and block design. Higher capillary cortisol was associated with lower flexibility on the Stroop task. Regarding protective factors, we found that greater psychological resilience was related to higher scores on the Addenbrooke's Cognitive Examination-III, letter-number sequencing, and verbal fluency. CONCLUSION in older people with low stress, apart from age, gender, and education, psychological resilience is a significant predictor of global cognitive status, working memory, and fluency. Likewise, stress is related to verbal memory functioning, working memory, and visuoconstructive abilities. Capillary cortisol level predicts cognitive flexibility. These findings may help to identify risk and protective factors for cognitive decline in older people. Training-based programs to reduce stress and increase psychological resilience may play an important role in preventing cognitive decline.
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Affiliation(s)
- Noelia Saez-Sanz
- Mind, Brain, and Behavior Research Center (CIMCYC), University of Granada, 18071 Granada, Spain
- Department of Psychology and Anthropology, University of Extremadura, 06006 Badajoz, Spain
| | - Isabel Peralta-Ramirez
- Mind, Brain, and Behavior Research Center (CIMCYC), University of Granada, 18071 Granada, Spain
- Department of Personality, Evaluation, and Psychological Treatment, University of Granada, 18071 Granada, Spain
| | - Raquel Gonzalez-Perez
- Department of Pharmacology, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), School of Pharmacy, Instituto de Investigación Biosanitaria ibs.GRANADA, University of Granada, 18012 Granada, Spain
| | - Enrique Vazquez-Justo
- Center for Research, Development and Innovation (CIDI-IEES), European Institute for Higher Studies, 4824-909 Fafe, Portugal
| | - Alfonso Caracuel
- Mind, Brain, and Behavior Research Center (CIMCYC), University of Granada, 18071 Granada, Spain
- Department of Developmental and Educational Psychology, University of Granada, 18071 Granada, Spain
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Gicas KM, Mejia-Lancheros C, Nisenbaum R, Wang R, Hwang SW, Stergiopoulos V. Cognitive determinants of community functioning and quality of life in homeless adults with mental illness: 6-year follow-up from the At Home/Chez Soi Study Toronto site. Psychol Med 2023; 53:362-370. [PMID: 33926584 DOI: 10.1017/s0033291721001550] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND High rates of physical and mental health comorbidities are associated with functional impairment among persons who are homeless. Cognitive dysfunction is common, but how it contributes to various functional outcomes in this population has not been well investigated. This study examines how cognition covaries with community functioning and subjective quality of life over a 6-year period while accounting for the effects of risk and protective factors. METHODS Participants were 349 homeless adults (mean age = 39.8) recruited from the Toronto site of the At Home/Chez Soi study, a large Canadian randomized control trial of Housing First. Participants completed up to four clinical evaluations over 6 years. Factor scores were created to index verbal learning and memory (vLM) and processing speed-cognitive flexibility (PSCF). The primary outcomes were community functioning and subjective quality of life. Risk factors included lifetime homelessness, mental health diagnoses, medical comorbidity, and childhood adversity. Linear mixed-effects models were conducted to examine cognition-functional outcome associations over time, with resilience as a moderator. RESULTS Better vLM (b = 0.787, p = 0.010) and PSCF (b = 1.66, p < 0.001) were associated with better community functioning, but not with quality of life. Resilience conferred a protective effect on subjective quality of life (b = 1.45, p = 0.011) but did not moderate outcomes. CONCLUSIONS Our findings suggest a need to consider the unique determinants of community functioning and quality of life among homeless adults. Cognition should be prioritized as a key intervention target within existing service delivery models to optimize long-term functional outcomes.
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Affiliation(s)
- K M Gicas
- Department of Psychology, York University, Toronto, Ontario, Canada
| | - C Mejia-Lancheros
- MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada
| | - R Nisenbaum
- MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - R Wang
- MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada
| | - S W Hwang
- MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada
- Division of General Internal Medicine, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - V Stergiopoulos
- MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
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7
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Njie-Carr VPS, Zhu S, Stafford KA, Tong W, Plankey M, Sharma A, Milam J, Cohen M, Diaz MM, Rubtsova AA, Fischl MA, Konkle-Parker D, Gustafson D, Rubin LH. Intersectionality of Socioecological Factors Associated With Cognitive Function Among Older Women With HIV in the United States: A Structural Equation Model Analysis Using Data From the Women's Interagency HIV Study. J Assoc Nurses AIDS Care 2023; 34:83-95. [PMID: 36656093 PMCID: PMC10079306 DOI: 10.1097/jnc.0000000000000376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
ABSTRACT Increased life expectancy of people with HIV has health implications including the intersection of the long-term use of antiretroviral treatment, inflammatory events, and age-related immunosenescence. In a cross-sectional study utilizing using the Socio-Eecological Model, we identified pathways of cognitive function (CF) among 448 women with HIV, 50 years and older. A structural equation model showed the direct effects of mood (β = -0.25, p < .01), comorbidities (β = --0.13, p < .05), race (β = --0.13, p < .05), and abuse (β = 0.27, p < .001) on the latent variable CF. Substance and alcohol use, depressive symptoms, cigarette smoking, and the number of comorbidities are important considerations when designing interventions utilizing using a multi-level and intersectional lens to maximize positive CF outcomes.
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Affiliation(s)
| | - Shijun Zhu
- School of Nursing, University of Maryland, Baltimore, Maryland, USA
| | | | - Weiqun Tong
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Michael Plankey
- Division of Infectious Diseases, School of Medicine, Georgetown University, Washington, District of Columbia, USA
| | - Anjali Sharma
- Department of Medicine, College of Medicine, Albert Einstein University Bronx, New York, USA
| | - Joel Milam
- Department of Epidemiology and Biostatistics, Program in Public Health, Susan & Henry Samueli College of Health Sciences, University of California Irvine, Irvine, California, USA
| | - Mardge Cohen
- Boston Health Care for the Homeless Program, Chicago, Illinois, USA
| | - Monica M. Diaz
- Department of Neurology, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Anna A. Rubtsova
- Department of Behavioral, Social, and Health Education Sciences, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Margaret A. Fischl
- School of Medicine, University of Miami Health Systems, Miami, Florida, USA
| | - Deborah Konkle-Parker
- Schools of Nursing, Medicine, and Population Health Sciences, University of Mississippi Medical Center, Jackson, Mississippi, USA
| | - Deborah Gustafson
- Department of Neurology, SUNY Downstate Health Sciences University, Brooklyn, New York, USA
| | - Leah H. Rubin
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
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8
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Cody SL, Miller GH, Fazeli PL, Wang G, Li W, Goodin BR, Vance DE. Preventing Neurocognitive Decline in Adults Aging with HIV: Implications for Practice and Research. J Alzheimers Dis 2023; 95:753-768. [PMID: 37599532 DOI: 10.3233/jad-230203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/22/2023]
Abstract
Mild to moderate forms of neurocognitive impairment persist among people living with HIV (PLWH), despite being virally suppressed on antiretroviral therapy. PLWH are disproportionally impacted by physiological and psychosocial comorbidities compared to those without HIV. As adults live longer with HIV, the neurocognitive burden of physiological and psychosocial stressors can impair everyday functioning and may contribute to the development of neurodegenerative diseases such as Alzheimer's disease. This article outlines neurocognitive consequences of everyday stressors in PLWH. While some lifestyle factors can exacerbate inflammatory processes and promote negative neurocognitive health, novel interventions including the use of cannabinoids may be neuroprotective for aging PLWH who are at risk for elevated levels of inflammation from comorbidities. Studies of integrated neurocognitive rehabilitation strategies targeting lifestyle factors are promising for improving neurocognitive health, and may over time, reduce the risk of Alzheimer's disease in PLWH.
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Affiliation(s)
- Shameka L Cody
- Capstone College of Nursing, The University of Alabama, Tuscaloosa, AL, USA
| | - Gabe H Miller
- Department of Sociology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Pariya L Fazeli
- School of Nursing, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Ge Wang
- Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Wei Li
- Department of Clinical and Diagnostic Sciences, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Burel R Goodin
- Department of Anesthesiology, Washington University Pain Center, Washington University, St. Louis, MO, USA
| | - David E Vance
- School of Nursing, University of Alabama at Birmingham, Birmingham, AL, USA
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9
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Ham L, Tang B, Kohli M, Jeste DV, Grant I, Moore DJ. Four-Year Trajectories of Internal Strengths and Socioemotional Support Among Middle-Aged and Older Adults with HIV. AIDS Behav 2023; 27:628-640. [PMID: 35908270 PMCID: PMC9908640 DOI: 10.1007/s10461-022-03798-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/14/2022] [Indexed: 01/31/2023]
Abstract
Positive psychological attributes are associated with better health outcomes, yet few studies have identified their underlying constructs and none have examined their temporal trajectories in clinical vs. non-clinical samples. From data collected over 4 years from people with HIV (PWH) and HIV-uninfected (HIV-) participants, we identified two latent factors (internal strengths; socioemotional support) based on responses to seven positive psychological attributes. Internal strengths increased over 4 years for PWH, but not for HIV- comparisons. Socioemotional support did not change significantly in either group. Lower internal strengths and worse socioemotional support were related to greater depressive symptoms. We speculate that improvement in internal strengths in PWH could reflect their being in care, but this requires further study to include PWH not in care. Given the apparent malleability of internal strengths and their association with improved health outcomes, these attributes can serve as promising intervention targets for PWH.
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Affiliation(s)
- Lillian Ham
- San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology, 220 Dickinson Street, San Diego, CA, 92103, USA.
- HIV Neurobehavioral Research Program, San Diego, CA, USA.
| | - Bin Tang
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
- HIV Neurobehavioral Research Program, San Diego, CA, USA
| | - Maulika Kohli
- San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology, 220 Dickinson Street, San Diego, CA, 92103, USA
- HIV Neurobehavioral Research Program, San Diego, CA, USA
| | - Dilip V Jeste
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
- Department of Neurosciences, University of California San Diego, La Jolla, CA, USA
- Sam and Rose Stein Institute for Research on Aging, University of California San Diego, La Jolla, CA, USA
| | - Igor Grant
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
- HIV Neurobehavioral Research Program, San Diego, CA, USA
| | - David J Moore
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA.
- HIV Neurobehavioral Research Program, San Diego, CA, USA.
- HIV Neurobehavioral Research Program, University of California San Diego, 220 Dickinson Street, Suite B (8231), San Diego, CA, 92103, USA.
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Ma Y, Leung P, Wang Y, Wang L. Psychological resilience, activities of daily living, and cognitive functioning among older male Tekun adults in rural long-term care facilities in China. SOCIAL WORK IN HEALTH CARE 2022; 61:445-467. [PMID: 36398735 DOI: 10.1080/00981389.2022.2147628] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 10/29/2022] [Accepted: 11/03/2022] [Indexed: 06/16/2023]
Abstract
Most of the rural long-term care (LTC) facilities in China are ill-equipped to manage the physical and psychological needs of older residents with dementia. These facilities mostly consist of older male Tekun (socially and economically vulnerable) adults. Preventing or delaying the onset of dementia is especially crucial for these older Tekun adults. A sample of 711 older male Tekun adults from rural LTC facilities in the Anhui province of China was used to investigate the association between psychological resilience and cognitive functioning, and to examine the moderating effect of activities of daily living (ADLs) on that association. Linear and quantile regression found that resilience was positively associated with cognitive functioning for the total sample, with a greater effect among those with a lower level of cognitive functioning. The benefit of resilience on cognitive functioning was observed only in participants with disability in ADLs. Our findings present evidence in support of interventions to foster psychological resilience and potentially improve cognitive functioning among vulnerable older adults. Resilience-promoting intervention is a strength-based approach that aligns with social work values and can be used in practice. The implications for social work practice were discussed.
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Affiliation(s)
- Ying Ma
- Graduate College of Social Work, University of Houston, Houston, TEXAS, USA
| | - Patrick Leung
- Graduate College of Social Work, University of Houston, Houston, TEXAS, USA
| | - Yi Wang
- School of Social Work, University of Iowa, Ames, Iowa, USA
| | - Li Wang
- Department of Healthcare Insurance, School of Healthcare Administration, Anhui Medical University, Hefei, Anhui, China
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11
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Hopkins CN, Lee CA, Lambert CC, Vance DE, Haase SR, Delgadillo JD, Fazeli PL. Psychological resilience is an independent correlate of health-related quality of life in middle-aged and older adults with HIV in the Deep South. J Health Psychol 2022; 27:2909-2921. [PMID: 35086380 PMCID: PMC9329492 DOI: 10.1177/13591053211072430] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Older people living with HIV (PLWH) are at risk for poorer health-related quality of life (HRQoL). Psychological resilience may protect HRQoL in this population. The sample included 174 predominately African American PLWH (age 40-73). Results indicated associations between resilience, socioeconomic status, cognitive performance, instrumental activities of daily living, personality, and depressive symptoms. HIV factors (e.g. viral load, duration of HIV) were not associated with resilience. Adjusting for confounders, resilience was associated with mental HRQoL. Understanding factors associated with resilience among older PLWH and the translation of resilience to HRQoL may inform interventions to improve well-being among individuals aging with HIV.
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Pope CN, Fazeli PL, Vance DE, Mrug S, Ball KK, Stavrinos D. Cognitive reserve attenuates the association between HIV serostatus and cognitive performance in adults living in the deep South. APPLIED NEUROPSYCHOLOGY. ADULT 2022; 29:993-1002. [PMID: 33054407 PMCID: PMC8044258 DOI: 10.1080/23279095.2020.1832095] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Cognitive reserve has shown evidence of mitigating HIV-related effects on cognition in people living with HIV (PWH). In a sample of adults residing in the Deep South, an underrepresented subgroup in the neuroAIDS literature, we assessed the association between HIV serostatus and age on processing speed, visual attention, executive function, and episodic memory and the attenuating effect of cognitive reserve. Adults (n = 138; 72 PWH; M age = 58.7 years, SD = 7.9 years; 75% nonwhite race) were recruited from a university clinic and the community. Verbal abilities served as a proxy for cognitive reserve. Regressions accounting for race, alcohol usage, and depressive symptoms were conducted for each cognitive outcome. Indirect effects were tested using the PROCESS macro. Being HIV seropositive was associated with worse executive function (b = -1.04, SE = 0.38, p = .007) and episodic memory (b = -39.94, SE = 12.54, p = .002) performance. Every year of age above the mean and nonwhite race was associated with worse cognitive performance (ps < .05). The addition of cognitive reserve to the model attenuated the HIV serostatus associations with executive function (BC 95% CI -0.770, -0.001) along with most associations between race and cognitive outcomes. Age associations remained for all cognitive outcomes (ps < .05). Findings highlight the importance of including verbal ability proxies of cognitive reserve when assessing cognition in PWH. Highlighting modifiable cognitive processes, such as cognitive reserve, will further the development of targeted cognitive interventions in this at-risk population.
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Affiliation(s)
| | | | | | - Sylvie Mrug
- University of Alabama at Birmingham, Department of Psychology
| | - Karlene K. Ball
- University of Alabama at Birmingham, Department of Psychology
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Thompson EC, Muhammad JN, Adimora AA, Chandran A, Cohen MH, Crockett KB, Goparaju L, Henderson E, Kempf MC, Konkle-Parker D, Kwait J, Mimiaga M, Ofotokun I, Rubin L, Sharma A, Teplin LA, Vance DE, Weiser SD, Weiss DJ, Wilson TE, Turan JM, Turan B. Internalized HIV-Related Stigma and Neurocognitive Functioning Among Women Living with HIV. AIDS Patient Care STDS 2022; 36:336-342. [PMID: 36099481 PMCID: PMC9810353 DOI: 10.1089/apc.2022.0041] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
The prevalence of HIV-associated neurocognitive impairment persists despite highly effective antiretroviral therapy (ART). In this study we explore the role of internalized stigma, acceptance of negative societal characterizations, and perceptions about people living with HIV (PLWH) on neurocognitive functioning (executive function, learning, memory, attention/working memory, psychomotor speed, fluency, motor skills) in a national cohort of women living with HIV (WLWH) in the United States. We utilized observational data from a multicenter study of WLWH who are mostly African American living in low-resource settings. Neurocognitive function was measured using an eight-test battery. A multiple linear regression model was constructed to investigate the relationship between internalized stigma and overall neurocognitive functioning (mean of all neurocognitive domain standardized T-scores), adjusting for age, education, race, previous neuropsychological battery scores, illicit drug use, viral load, and years on ART. Our analysis revealed that internalized HIV-related stigma is significantly associated with worse performance on individual domain tests and overall neurocognitive performance (B = 0.27, t = 2.50, p = 0.01). This suggests HIV-related internalized stigma may be negatively associated with neurocognitive functioning for WLWH. This finding highlights a specific psychosocial factor associated with poor neurocognitive function that may be targeted to better promote the health of PLWH. Future research on the longitudinal relationship between these variables and the effects of other stigma dimensions on poor neurocognitive function would provide further insights into the pathways explaining the relationship between internalized stigma and neurocognition.
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Affiliation(s)
- Emma C. Thompson
- Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Josh N. Muhammad
- School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Adoara A. Adimora
- School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Aruna Chandran
- School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Mardge H. Cohen
- Chicago Women's Interagency HIV Study, Chicago, Illinois, USA
| | - Kaylee B. Crockett
- School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Lakshmi Goparaju
- School of Medicine, Georgetown University, Washington, District of Columbia, USA
| | - Emmett Henderson
- School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Mirjam-Colette Kempf
- School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Deborah Konkle-Parker
- Department of Medicine, University of Mississippi Medical Center, Jackson, Mississippi, USA
| | - Jennafer Kwait
- Whitman-Walker Institute, Washington, District of Columbia, USA
| | - Matthew Mimiaga
- School of Public Health, University of California Los Angeles, Los Angeles, California, USA
| | - Igho Ofotokun
- School of Medicine, Emory University, Atlanta, Georgia, USA
| | - Leah Rubin
- School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Anjala Sharma
- Albert Einstein College of Medicine, Bronx, New York, USA
| | - Linda A. Teplin
- School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - David E. Vance
- School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Sheri D. Weiser
- Department of Medicine, University of California San Francisco, San Francisco, California, USA
| | - Deborah J. Weiss
- Department of Psychiatry & Behavioral Sciences, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Tracey E. Wilson
- School of Public Health, SUNY Downstate Health Sciences University, Brooklyn, New York, USA
| | - Janet M. Turan
- School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Bulent Turan
- Department of Psychology, Koc University, Istanbul, Turkey
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Fazeli PL, Hopkins CN, Wells A, Lambert CC, Turan B, Kempf MC, Vance DE. Examining the Acceptability of a Resilience Building Intervention Among Adults Aging With HIV. J Assoc Nurses AIDS Care 2022; 33:155-167. [PMID: 33427766 PMCID: PMC8257766 DOI: 10.1097/jnc.0000000000000229] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
ABSTRACT Few interventions have targeted resilience resources in people living with HIV (PLWH). We tested the acceptability of an existing resilience intervention in middle-age and older PLWH. Fourteen PLWH attended one 3-hr group session, which included videos, quizzes, and written activities. Participants provided quantitative and qualitative feedback. The mean acceptability rating was 8.71 (1.27) on a 10-point scale. A majority of participants reported that the intervention was an appropriate length; that it improved their resilience, mood, and ability to manage HIV; and that they would likely continue using the tools. Average content retention accuracy was 75% (12.66). Qualitative feedback suggested addressing HIV-specific stressors, including disclosure concerns, stigma, health concerns, and treatment adherence. The resilience intervention was deemed highly acceptable among older PLWH. Uptake may increase by addressing HIV-specific stressors and improving comprehensibility. Future research should further refine and test the efficacy of a modified version of the intervention.
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Affiliation(s)
- Pariya L Fazeli
- Pariya L. Fazeli, PhD, is an Associate Professor, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Cierra N. Hopkins, BS, is a Program Manager, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Andrea Wells, MSN, is a Doctoral Student, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Crystal Chapman Lambert, PhD, is an Assistant Professor, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Bulent Turan, PhD, is an Associate Professor, Department of Psychology, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Mirjam-Colette Kempf, PhD, MPH, is a Professor, School of Nursing, Departments of Epidemiology and Health Behavior, and School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
- David E. Vance, PhD, is a Professor, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Cierra N Hopkins
- Pariya L. Fazeli, PhD, is an Associate Professor, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Cierra N. Hopkins, BS, is a Program Manager, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Andrea Wells, MSN, is a Doctoral Student, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Crystal Chapman Lambert, PhD, is an Assistant Professor, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Bulent Turan, PhD, is an Associate Professor, Department of Psychology, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Mirjam-Colette Kempf, PhD, MPH, is a Professor, School of Nursing, Departments of Epidemiology and Health Behavior, and School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
- David E. Vance, PhD, is a Professor, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Andrea Wells
- Pariya L. Fazeli, PhD, is an Associate Professor, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Cierra N. Hopkins, BS, is a Program Manager, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Andrea Wells, MSN, is a Doctoral Student, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Crystal Chapman Lambert, PhD, is an Assistant Professor, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Bulent Turan, PhD, is an Associate Professor, Department of Psychology, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Mirjam-Colette Kempf, PhD, MPH, is a Professor, School of Nursing, Departments of Epidemiology and Health Behavior, and School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
- David E. Vance, PhD, is a Professor, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Crystal Chapman Lambert
- Pariya L. Fazeli, PhD, is an Associate Professor, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Cierra N. Hopkins, BS, is a Program Manager, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Andrea Wells, MSN, is a Doctoral Student, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Crystal Chapman Lambert, PhD, is an Assistant Professor, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Bulent Turan, PhD, is an Associate Professor, Department of Psychology, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Mirjam-Colette Kempf, PhD, MPH, is a Professor, School of Nursing, Departments of Epidemiology and Health Behavior, and School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
- David E. Vance, PhD, is a Professor, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Bulent Turan
- Pariya L. Fazeli, PhD, is an Associate Professor, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Cierra N. Hopkins, BS, is a Program Manager, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Andrea Wells, MSN, is a Doctoral Student, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Crystal Chapman Lambert, PhD, is an Assistant Professor, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Bulent Turan, PhD, is an Associate Professor, Department of Psychology, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Mirjam-Colette Kempf, PhD, MPH, is a Professor, School of Nursing, Departments of Epidemiology and Health Behavior, and School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
- David E. Vance, PhD, is a Professor, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Mirjam-Colette Kempf
- Pariya L. Fazeli, PhD, is an Associate Professor, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Cierra N. Hopkins, BS, is a Program Manager, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Andrea Wells, MSN, is a Doctoral Student, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Crystal Chapman Lambert, PhD, is an Assistant Professor, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Bulent Turan, PhD, is an Associate Professor, Department of Psychology, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Mirjam-Colette Kempf, PhD, MPH, is a Professor, School of Nursing, Departments of Epidemiology and Health Behavior, and School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
- David E. Vance, PhD, is a Professor, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - David E Vance
- Pariya L. Fazeli, PhD, is an Associate Professor, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Cierra N. Hopkins, BS, is a Program Manager, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Andrea Wells, MSN, is a Doctoral Student, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Crystal Chapman Lambert, PhD, is an Assistant Professor, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Bulent Turan, PhD, is an Associate Professor, Department of Psychology, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Mirjam-Colette Kempf, PhD, MPH, is a Professor, School of Nursing, Departments of Epidemiology and Health Behavior, and School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
- David E. Vance, PhD, is a Professor, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
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Woods SP, Matchanova A, Alex C, Rahman S, Babicz MA, Sullivan KL, Avci G, Hasbun R, Fazeli PL, Giordano TP. A pilot study of cognition and creativity among persons with HIV disease referred for neuropsychological evaluation. J Neurovirol 2022; 28:595-605. [PMID: 36094729 PMCID: PMC9466317 DOI: 10.1007/s13365-022-01095-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 08/15/2022] [Accepted: 08/23/2022] [Indexed: 01/13/2023]
Abstract
Creativity can help people to innovate, overcome obstacles, and successfully navigate challenges in daily life. Some aspects of creativity rely on the prefrontostriatal loops and executive functions, which can be compromised in persons with HIV (PWH). This pilot study examined whether neuropsychological functioning plays a role in creativity in PWH. A consecutive series of 41 PWH who were referred to an urban neuropsychology clinic in southeastern Texas were enrolled. Participants completed the Abbreviated Torrance Test for Adults (ATTA) to measure creativity, from which standardized creativity scores of fluency, originality, elaboration, and flexibility were derived. Participants also completed several measures of everyday functioning and a brief clinical neuropsychological battery measuring executive functions, motor skills, memory, and visuoconstruction. Global neuropsychological functioning showed a large, positive association with ATTA creativity performance that did not vary meaningfully by creativity domain and was independent of premorbid IQ. ATTA creativity scores were not associated with any measure of everyday functioning. Findings from this pilot study suggest that higher levels of neuropsychological functioning may support multiple dimensions of creativity in adults with HIV disease. Future studies might examine whether creativity moderates the association between HIV-associated neurocognitive impairment and various health behaviors (e.g., adherence, appointment attendance).
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Affiliation(s)
- Steven Paul Woods
- grid.266436.30000 0004 1569 9707Department of Psychology, University of Houston, 3695 Cullen Boulevard, 126 Heyne Building (Ste. 239d), Houston, TX 77004 USA
| | - Anastasia Matchanova
- grid.266436.30000 0004 1569 9707Department of Psychology, University of Houston, 3695 Cullen Boulevard, 126 Heyne Building (Ste. 239d), Houston, TX 77004 USA
| | - Christina Alex
- grid.411377.70000 0001 0790 959XDepartment of Psychological and Brain Sciences, Indiana University, Bloomington, IN USA
| | - Samina Rahman
- grid.266436.30000 0004 1569 9707Department of Psychology, University of Houston, 3695 Cullen Boulevard, 126 Heyne Building (Ste. 239d), Houston, TX 77004 USA
| | - Michelle A. Babicz
- grid.266436.30000 0004 1569 9707Department of Psychology, University of Houston, 3695 Cullen Boulevard, 126 Heyne Building (Ste. 239d), Houston, TX 77004 USA
| | - Kelli L. Sullivan
- grid.266436.30000 0004 1569 9707Department of Psychology, University of Houston, 3695 Cullen Boulevard, 126 Heyne Building (Ste. 239d), Houston, TX 77004 USA
| | - Gunes Avci
- grid.266436.30000 0004 1569 9707Department of Psychology, University of Houston, 3695 Cullen Boulevard, 126 Heyne Building (Ste. 239d), Houston, TX 77004 USA
| | - Rodrigo Hasbun
- grid.267308.80000 0000 9206 2401Department of Medicine, University of Texas Health Science Center, Houston, TX USA
| | - Pariya L. Fazeli
- grid.265892.20000000106344187School of Nursing, University of Alabama at Birmingham, Birmingham, AL USA
| | - Thomas P. Giordano
- grid.39382.330000 0001 2160 926XDepartment of Medicine, Center for Innovation in Quality, Effectiveness and Safety, Michael E. DeBakey VA Medical Center, Baylor College of Medicine, Houston, TX USA
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16
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Parallels Between NeuroHIV and NeuroCOVID-19: Considerations for a Post-COVID-19 Era. J Assoc Nurses AIDS Care 2021; 32:e55-e59. [PMID: 35137724 PMCID: PMC8384133 DOI: 10.1097/jnc.0000000000000265] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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17
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Waldrop D, Irwin C, Nicholson WC, Lee CA, Webel A, Fazeli PL, Vance DE. The Intersection of Cognitive Ability and HIV: A Review of the State of the Nursing Science. J Assoc Nurses AIDS Care 2021; 32:306-321. [PMID: 33449578 PMCID: PMC8091162 DOI: 10.1097/jnc.0000000000000232] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
ABSTRACT Neurocognitive problems have been endemic to the HIV epidemic since its beginning. Four decades later, these problems persist, but currently, they are attributed to HIV-induced inflammation, the long-term effects of combination antiretroviral therapy, lifestyle (i.e., physical activity, drug use), psychiatric, and age-associated comorbidities (i.e., heart disease, hypertension). In many cases, persons living with HIV (PLWH) may develop cognitive problems as a function of accelerated or accentuated normal aging and lifestyle rather than HIV itself. Nonetheless, such cognitive impairments can interfere with HIV care, including medication adherence and attending clinic appointments. With more than half of PLWH 50 years and older, and 30%-50% of all PLWH meeting the criteria for HIV-associated neurocognitive disorder, those aging with HIV may be more vulnerable to developing cognitive problems. This state of the science article provides an overview of current issues and provides implications for practice, policy, and research to promote successful cognitive functioning in PLWH.
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Affiliation(s)
- Drenna Waldrop
- Drenna Waldrop, PhD, is a Professor and Assistant Dean for Research Operations & Training, Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia, USA. Crista Irwin, BSN, RN, is a PhD Student, Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia, USA. W. Chance Nicholson, PhD, MSN, PMHNP-BC, is a Nurse Practitioner and Assistant Professor, Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia, USA. Cheryl A. Lee, BSN, RN, is a PhD Student, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA. Allison Webel, PhD, RN, FAAN, is an Associate Professor, Frances Bolton School of Nursing, Case Western University, Cleveland, Ohio, USA. Pariya L. Fazeli, PhD, is an Associate Professor, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA. David E. Vance, PhD, MGS, is a Professor, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Crista Irwin
- Drenna Waldrop, PhD, is a Professor and Assistant Dean for Research Operations & Training, Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia, USA. Crista Irwin, BSN, RN, is a PhD Student, Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia, USA. W. Chance Nicholson, PhD, MSN, PMHNP-BC, is a Nurse Practitioner and Assistant Professor, Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia, USA. Cheryl A. Lee, BSN, RN, is a PhD Student, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA. Allison Webel, PhD, RN, FAAN, is an Associate Professor, Frances Bolton School of Nursing, Case Western University, Cleveland, Ohio, USA. Pariya L. Fazeli, PhD, is an Associate Professor, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA. David E. Vance, PhD, MGS, is a Professor, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - W. Chance Nicholson
- Drenna Waldrop, PhD, is a Professor and Assistant Dean for Research Operations & Training, Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia, USA. Crista Irwin, BSN, RN, is a PhD Student, Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia, USA. W. Chance Nicholson, PhD, MSN, PMHNP-BC, is a Nurse Practitioner and Assistant Professor, Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia, USA. Cheryl A. Lee, BSN, RN, is a PhD Student, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA. Allison Webel, PhD, RN, FAAN, is an Associate Professor, Frances Bolton School of Nursing, Case Western University, Cleveland, Ohio, USA. Pariya L. Fazeli, PhD, is an Associate Professor, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA. David E. Vance, PhD, MGS, is a Professor, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Cheryl A. Lee
- Drenna Waldrop, PhD, is a Professor and Assistant Dean for Research Operations & Training, Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia, USA. Crista Irwin, BSN, RN, is a PhD Student, Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia, USA. W. Chance Nicholson, PhD, MSN, PMHNP-BC, is a Nurse Practitioner and Assistant Professor, Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia, USA. Cheryl A. Lee, BSN, RN, is a PhD Student, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA. Allison Webel, PhD, RN, FAAN, is an Associate Professor, Frances Bolton School of Nursing, Case Western University, Cleveland, Ohio, USA. Pariya L. Fazeli, PhD, is an Associate Professor, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA. David E. Vance, PhD, MGS, is a Professor, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Allison Webel
- Drenna Waldrop, PhD, is a Professor and Assistant Dean for Research Operations & Training, Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia, USA. Crista Irwin, BSN, RN, is a PhD Student, Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia, USA. W. Chance Nicholson, PhD, MSN, PMHNP-BC, is a Nurse Practitioner and Assistant Professor, Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia, USA. Cheryl A. Lee, BSN, RN, is a PhD Student, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA. Allison Webel, PhD, RN, FAAN, is an Associate Professor, Frances Bolton School of Nursing, Case Western University, Cleveland, Ohio, USA. Pariya L. Fazeli, PhD, is an Associate Professor, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA. David E. Vance, PhD, MGS, is a Professor, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Pariya L. Fazeli
- Drenna Waldrop, PhD, is a Professor and Assistant Dean for Research Operations & Training, Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia, USA. Crista Irwin, BSN, RN, is a PhD Student, Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia, USA. W. Chance Nicholson, PhD, MSN, PMHNP-BC, is a Nurse Practitioner and Assistant Professor, Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia, USA. Cheryl A. Lee, BSN, RN, is a PhD Student, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA. Allison Webel, PhD, RN, FAAN, is an Associate Professor, Frances Bolton School of Nursing, Case Western University, Cleveland, Ohio, USA. Pariya L. Fazeli, PhD, is an Associate Professor, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA. David E. Vance, PhD, MGS, is a Professor, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - David E. Vance
- Drenna Waldrop, PhD, is a Professor and Assistant Dean for Research Operations & Training, Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia, USA. Crista Irwin, BSN, RN, is a PhD Student, Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia, USA. W. Chance Nicholson, PhD, MSN, PMHNP-BC, is a Nurse Practitioner and Assistant Professor, Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia, USA. Cheryl A. Lee, BSN, RN, is a PhD Student, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA. Allison Webel, PhD, RN, FAAN, is an Associate Professor, Frances Bolton School of Nursing, Case Western University, Cleveland, Ohio, USA. Pariya L. Fazeli, PhD, is an Associate Professor, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA. David E. Vance, PhD, MGS, is a Professor, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
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Vance DE, Heaton K, Antia L, Frank J, Moneyham L, Harper D, Meneses K. Alignment of a PhD program in nursing with the AACN report on the research-focused doctorate in nursing: A descriptive analysis. J Prof Nurs 2020; 36:604-610. [DOI: 10.1016/j.profnurs.2020.08.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 08/14/2020] [Accepted: 08/20/2020] [Indexed: 11/25/2022]
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Cognitive Reserve Over the Lifespan: Neurocognitive Implications for Aging With HIV. J Assoc Nurses AIDS Care 2020; 30:e109-e121. [PMID: 30865059 DOI: 10.1097/jnc.0000000000000071] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Approximately 59% of adults living with HIV experience HIV-associated neurocognitive disorder, a collection of symptoms and cognitive deficits in various cognitive domains. As the HIV population ages, the prevalence and severity of such cognitive deficits are expected to grow. Understanding how these cognitive deficits manifest is important for nurses and health care providers. This article provides an overview of cognitive reserve and evidence of how it is compromised by HIV, aging, and individual characteristics. Within this context of cognitive reserve, the role of neuroinflammation, neurotoxicity, substance use, comorbidities, depression and anxiety, social isolation, and sedentary lifestyle is reviewed. From this, strategies used to address cognitive deficits are provided, including topics such as psychostimulants, cognitive training, multimodal lifestyle interventions, and compensation strategies. Scenarios of successful and unsuccessful cognitive aging are presented to provide a lifespan perspective of cognitive reserve. Implications for clinical practice and research are provided, as it relates to aging.
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Brown MJ, Trask JS, Zhang J, Haider MR, Li X. Sociodemographic and psychosocial correlates of resilience among older adults living with HIV in the Deep South. J Health Psychol 2020; 26:2010-2019. [PMID: 31912745 DOI: 10.1177/1359105319897783] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
This cross-sectional study assessed the psychosocial and sociodemographic correlates of resilience among older adults living with HIV. Data were obtained from 103 men and 53 women aged 50 years and older in South Carolina. Multivariable linear regression models showed that employment (any) (B: 3.52; 95% confidence interval : 1.04, 5.99), education (B: -3.56; 95% confidence interval : -6.15, -0.98), time since diagnosis (B: 0.18; 95% confidence interval : 0.04, 0.31), and social support (B: 0.27; 95% confidence interval : 0.20, 0.34) were associated with resilience. Interventions tailored for older adults living with HIV to support resilience could facilitate social support, particularly for those who are newly diagnosed, unemployed, and have lower educational attainment.
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Solomon P, O'Brien KK, McGuff R, Sankey M. Living strategies for disability in men ageing with HIV in Ontario, Canada: a longitudinal qualitative study. BMJ Open 2019; 9:e031262. [PMID: 31481379 PMCID: PMC6731853 DOI: 10.1136/bmjopen-2019-031262] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES To examine the living strategies used by older men living with HIV to deal with the episodic nature of disability and associated uncertainty, over time. DESIGN Qualitative longitudinal study in which men living with HIV were interviewed on four occasions over 20 months. SETTING Men were recruited from HIV community organisations in Canada. PARTICIPANTS 14 men with a median age of 57.5 years and median time since diagnosis of 21.5 years. RESULTS Five themes depict the living strategies used to deal with the episodic nature of disability and uncertainty over time. Actively engaging in problem-solving by prioritising and modifying activities and avoiding stress, advocating for support, being positive and future oriented, engaging in healthy pursuits and providing social support to others helped men to mitigate their disability. By following participants over time, we were able to gather insights into triggers of episodes of disability, and perceptions of the success of implementing their living strategies and avoiding uncertainty. CONCLUSIONS Participants used living strategies to deal with uncertainty and mitigate episodes of disability over time. This study supports the importance of programmes that promote self-management for older men living with HIV through helping them identify triggers of disability, set realistic goals and problem-solve. These may help build self-efficacy, increase sense of control, and decrease feelings of uncertainty and episodes of disability.
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Affiliation(s)
- Patricia Solomon
- School of Rehabilitation Science, McMaster University, Faculty of Health Sciences, Hamilton, Ontario, Canada
| | - Kelly K O'Brien
- Department of Physical Therapy, University of Toronto, Faculty of Medicine, Toronto, Ontario, Canada
| | - Rebecca McGuff
- School of Rehabilitation Science, McMaster University, Faculty of Health Sciences, Hamilton, Ontario, Canada
| | - Michelle Sankey
- School of Rehabilitation Science, McMaster University, Faculty of Health Sciences, Hamilton, Ontario, Canada
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