1
|
Aminde JAA, Burton NW, Thng C, Clanchy K. A systematic review and meta-analysis evaluating the effectiveness of minimally supervised home and community exercise interventions in improving physical activity, body adiposity and quality of life in adults living with HIV. Prev Med 2024; 189:108144. [PMID: 39353472 DOI: 10.1016/j.ypmed.2024.108144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2024] [Revised: 09/25/2024] [Accepted: 09/26/2024] [Indexed: 10/04/2024]
Abstract
People living with HIV (PLWH) are physically inactive and risk cardiometabolic dysfunction. Home and community exercise (HCE) is pragmatic, cost-effective and improves health in varied chronic conditions. This review aimed to synthesize evidence on the effectiveness of minimally supervised HCE for physical activity (PA), adiposity, quality of life (QoL), and other physical and psychological health indices for PLWH. METHODS Databases were searched for studies published January 2000 to April 2023. Risk of bias in experimental and quasi-experimental studies was assessed with the Cochrane Risk-of-Bias for Randomized Trials and Risk-of-Bias in Non-Randomized Studies of Interventions tools, respectively. A random-effects meta-analysis was conducted. RESULTS From 9648 records, 13 studies (14 HCE groups) with 857 PLWH (average ages 29-56 years) were included; 12 comparator and one single group trial. Aerobic and strength HCE significantly improved PA relative to control by 0.377 units (95 %CI = 0.097, 0.657; p = 0.008) and 1097steps/day (95 %CI = 39.27, 2156.62; p = 0.042). There was a reduction from baseline in percent body fat of 3.36 % (95 %CI = -6.10, 0.42; p = 0.025), but no change in BMI (-0.21 kg/m2; 95 %CI = -0.67, 0.24; p = 0.351) relative to control. HCE improved QoL relative to control in the physical domain by 13points (95 %CI = 6.15, 19.86; p < 0.001), but not in other domains like general health (6.6points; 95 %CI = -1.19, 14.36; p < 0.097). HCE completed at moderate intensity or higher was associated with improvement in outcomes more so than lower intensity HCE. Walking-only interventions were at least as beneficial as other activities. No adverse events were recorded. CONCLUSION Minimally supervised HCE can improve PA, body fat, physical QoL and other health indices in PLWH.
Collapse
Affiliation(s)
- Jeannine Anyingu A Aminde
- Health Centre, School of Health Sciences and Social Work (SHS), Gold Coast campus, Griffith University, Queensland 4222, Australia.
| | - Nicola W Burton
- School of Applied Psychology, Griffith University, Queensland, Australia; Centre for Mental Health, Griffith University, Queensland, Australia.
| | - Caroline Thng
- Gold Coast University Hospital, Queensland, Australia.
| | - Kelly Clanchy
- Health Centre, School of Health Sciences and Social Work (SHS), Gold Coast campus, Griffith University, Queensland 4222, Australia; The Hopkins Centre, Griffith University, Queensland, Australia.
| |
Collapse
|
2
|
Smith WP. Negative Lifestyle Factors Specific to Aging Persons Living with HIV and Multimorbidity. J Int Assoc Provid AIDS Care 2024; 23:23259582241245228. [PMID: 39051608 PMCID: PMC11273731 DOI: 10.1177/23259582241245228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 02/28/2024] [Accepted: 03/18/2024] [Indexed: 07/27/2024] Open
Abstract
The primary goal of medical care during the pre-antiretroviral therapy (ART) era was to keep persons living with human immunodeficiency virus (HIV) alive, whereas since the advent of ART, the treatment objective has shifted to decreasing viral loads and infectiousness while increasing CD4+ T-cell counts and longevity. The health crisis, however, is in preventing and managing multimorbidity (ie, type 2 diabetes), which develops at a more accelerated or accentuated pace among aging persons living with HIV. Relative to the general population and age-matched uninfected adults, it may be more difficult for aging HIV-positive persons who also suffer from multimorbidity to improve negative lifestyle factors to the extent that their behaviors could support the prevention and management of diseases. With recommendations and a viable solution, this article explores the impact of negative lifestyle factors (ie, poor mental health, suboptimal nutrition, physical inactivity, alcohol use) on the health of aging individuals living with HIV.
Collapse
|
3
|
Brown MJ, Nkwonta CA, Kaur A, James T, Haider MR, Weissman SB, Hansen NB, Heckman TG, Li X. Intervention program needs for older adults living with HIV who are childhood sexual abuse survivors. Aging Ment Health 2022; 26:2195-2201. [PMID: 34766546 PMCID: PMC9095752 DOI: 10.1080/13607863.2021.1998358] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Accepted: 10/17/2021] [Indexed: 01/25/2023]
Abstract
OBJECTIVES Childhood sexual abuse (CSA) prevalence estimates range from 8-11% among older adults and may range from 16 to 22% among older adults living with HIV (OALH). CSA experiences can still impact the quality of life of older adults. To the best of our knowledge, however, there are no CSA-focused interventions tailored for OALH. Using a qualitative approach, this study characterized the desired components of a trauma-focused intervention for OALH who are CSA survivors. METHODS Twenty-four (24) adults aged 50 years of age or older who were living with HIV and had experienced CSA were recruited from a large HIV immunology center in South Carolina. Participants completed in-depth, qualitative, semi-structured interviews. We iteratively examined verbatim transcripts using thematic analysis. RESULTS Three main themes emerged: program format and modality, program content, and program coordinator. Most participants expressed a desire for a trauma-focused intervention program in which the CSA experience was addressed and they could talk to someone either individually, as a group, and/or both. CONCLUSION A trauma-focused intervention addressing CSA may be helpful for OALH who are CSA survivors. Future research should focus on designing and implementing age-appropriate interventions addressing the CSA experience, increasing resilience, and developing adaptive coping skills.
Collapse
Affiliation(s)
- Monique J. Brown
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
- South Carolina SmartState Center for Healthcare Quality, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
- Rural and Minority Health Research Center, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
- Office for the Study on Aging, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
| | | | - Amandeep Kaur
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
| | - Titilayo James
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
| | - Mohammad Rifat Haider
- Health Policy and Management, College of Public Health, University of Georgia, Athens, Georgia
| | - Sharon B. Weissman
- School of Medicine, University of South Carolina, Columbia, South Carolina
| | - Nathan B. Hansen
- Health Promotion and Behavior, College of Public Health, University of Georgia, Athens, Georgia
| | - Timothy G. Heckman
- Health Promotion and Behavior, College of Public Health, University of Georgia, Athens, Georgia
| | - Xiaoming Li
- South Carolina SmartState Center for Healthcare Quality, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
| |
Collapse
|
4
|
Shim MS, Noh D. Effects of Physical Activity Interventions on Health Outcomes among Older Adults Living with HIV: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:8439. [PMID: 35886293 PMCID: PMC9317429 DOI: 10.3390/ijerph19148439] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/04/2022] [Revised: 07/07/2022] [Accepted: 07/09/2022] [Indexed: 01/27/2023]
Abstract
There is a lack of evidence regarding the effects of exercise on older individuals living with HIV. This systematic review and meta-analysis examined previous studies on physical activity interventions for people living with HIV aged ≥50 years. The effectiveness of the interventions on various physical and psychological health outcomes was evaluated. Databases used for this review included PubMed, EMBASE, CINAHL, and Cochrane Library CENTRAL. Twelve randomized controlled trials on physical activity interventions for people ≥50 years and living with HIV were included. Standardized mean differences were calculated using random-effect models. All effect sizes were expressed using Cohen's d values and their 95% confidence intervals (CIs). Physical activity interventions had a significant effect on walking capacity (Cohen's d: 0.467; 95% CI [0.069, 0.865]). The effect sizes on cardiorespiratory fitness, weight, and health-related quality of life were not significant. These findings suggest that physical activity interventions for people living with HIV aged ≥50 years are effective for the improvement of walking capacity. Further larger and higher-quality studies are required to determine the full effects of physical activity interventions on various health outcomes among older adults with HIV.
Collapse
Affiliation(s)
- Mi-So Shim
- Mo-Im Kim Nursing Research Institute, College of Nursing, Yonsei University, Seoul 03722, Korea;
| | - Dabok Noh
- College of Nursing, Eulji University, Seongnam-si 13135, Korea
| |
Collapse
|
5
|
Hidrus A, Kueh YC, Norsa’adah B, Kim Y, Chang YK, Kuan G. Structural equation model of psychological constructs of transtheoretical model, motives for physical activity, and amount of physical activity among people with type 2 diabetes mellitus in Malaysia. PLoS One 2022; 17:e0266104. [PMID: 35358248 PMCID: PMC8970478 DOI: 10.1371/journal.pone.0266104] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2021] [Accepted: 03/15/2022] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND This study aimed determine the structural relationship between psychological constructs of the transtheoretical model (TTM; processes of change, decisional balance, and exercise self-efficacy), motives for physical activity (PA), and amount of PA among Malaysians with type 2 diabetes mellitus (T2DM). METHOD All participants were recruited from the Hospital Universiti Sains Malaysia using a cross-sectional study design with purposive) sampling method. A total of 331 participants were recruited for the present study. Before participation in the study, they were informed that participation in the study was totally voluntary. Those who agreed to participate voluntarily were required to complete the self-administered questionnaire set, which included the processes of change, decisional balance, exercise self-efficacy, physical activity and leisure motivation, and international physical activity questionnaires. Data analysis of structural equation modeling was performed using Mplus 8. RESULTS From the 331 participants, most of whom were male (52%) and Malay (89.4%), with a mean age of 62.6 years (standard deviation = 10.29). The final structural equation model fit the data well based on several fit indices [Root Mean Square Error of Approximation (RMSEA) = 0.059, Comparative Fit Index (CFI) = 0.953, Tucker-Lewis Index (TLI) = 0.925, Standardized Root Mean Square Residual (SRMR) = 0.031]. A total of 16 significant path relationships linked between the TTM, motives for PA, and amount of PA. CONCLUSION The pros of decisional balance, others' expectations, and psychological condition were constructs that directly affected PA, whereas the other constructs had a significant indirect relationship with the amount of PA. A positive mindset is crucial in deciding a behavioral change toward an active lifestyle in people with T2DM.
Collapse
Affiliation(s)
- Aizuddin Hidrus
- Biostatistics and Research Methodology Unit, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
- Public Health Medicine Department, Faculty of Medicine and Health Science, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia
| | - Yee Cheng Kueh
- Biostatistics and Research Methodology Unit, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
- Hospital Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
| | - Bachok Norsa’adah
- Biostatistics and Research Methodology Unit, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
| | - YoungHo Kim
- Department of Sport Sciences, Seoul National University of Science and Technology, Nowon-gu, Seoul, Korea
| | - Yu-Kai Chang
- Department of Physical Education and Sport Sciences, National Taiwan Normal University, Taipei, Taiwan
- Institute for Research Excellence in Learning Science, National Taiwan Normal University, Taipei, Taiwan
| | - Garry Kuan
- Exercise and Sports Science, School of Health Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
- Department of Life Sciences, Brunel University London, London, United Kingdom
| |
Collapse
|
6
|
Chetty L, Cobbing S, Chetty V. Physical Activity and Exercise for Older People Living with HIV: A Scoping Review. HIV AIDS (Auckl) 2021; 13:1079-1090. [PMID: 34984030 PMCID: PMC8702781 DOI: 10.2147/hiv.s336886] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Accepted: 11/12/2021] [Indexed: 12/19/2022] Open
Abstract
INTRODUCTION Improvements in physical, mental, and overall quality of life are well documented in younger HIV populations who exercise. Exercise guidelines exist for younger HIV populations, but none for older people living with HIV (OPLWH), especially 50 years of age and older. Our aim was to map the existing literature on the effects of exercise and physical activity prescriptions for OPLWH. METHODS We conducted a scoping review using the methodological framework proposed by the Joanna Briggs Institute. Online searches on five research databases yielded 503 published articles. Fifteen studies met the study's inclusion criteria. RESULTS The most commonly used parameters of exercise included aerobic and strength training, as well as a combination of both. The physical, psychological and Quality of Life (QoL) impact of physical activity and its effect on OPLWH is evidently beneficial. Overall, a positive correlation between exercise and physical, mental and functional status was observed. No adverse side effects, or safety and efficacy concerns, during the use of exercise were reported. CONCLUSION This review confirms the dearth of evidence on physical activity and exercise in the context of OPLWH. Of greater concern is the fact that there were no studies conducted in sub-Saharan Africa, the global region with by far the highest HIV burden.
Collapse
Affiliation(s)
- Levin Chetty
- School of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - Saul Cobbing
- School of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - Verusia Chetty
- School of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
| |
Collapse
|
7
|
Jemmott JB, Jemmott LS, Zhang J, Icard LD, Kelly TA, Frank I, Bellamy SL. Effects of a Health Promotion Intervention on Physical Activity in African American Men Living with HIV: Randomized Controlled Trial. AIDS Patient Care STDS 2021; 35:377-384. [PMID: 34551263 PMCID: PMC8573803 DOI: 10.1089/apc.2021.0039] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
HIV and its treatment with antiretroviral therapy increase the risk of noncommunicable diseases (NCDs) tied to physical inactivity. Older African American men are also at high risk for NCDs. We tested the efficacy of a theory-based intervention to increase adherence to federal aerobic and muscle-strengthening physical activity (PA) guidelines among African American men aged 40 years and older living with HIV. We randomized African American men aged 40 years and older living with HIV to a three-session social cognitive theory-informed health promotion intervention targeting PA or a one-session health awareness control condition. The primary outcome was PA guideline adherence assessed (self-reported) preintervention, immediate postintervention, and 3, 6, and 12 months postintervention. Secondary outcomes were the number of days on which participants reported moderate-intensity aerobic PA, vigorous-intensity aerobic PA, and muscle-strengthening PA in the past 7 days. Of 302 participants, 255 completed the 12-month postintervention measures. Generalized estimated equation logistic regression indicated that the health promotion intervention participants had higher odds of meeting PA guidelines than health awareness control participants, adjusting for baseline adherence (p = 0.011). Health promotion intervention participants also reported more muscle-strengthening PA (p = 0.001), vigorous-intensity aerobic PA (p = 0.049), and moderate-intensity aerobic PA (p = 0.010) than control participants. The rise in self-reported adherence to PA guidelines and improvements in muscle-strengthening and aerobic PA considered separately suggest that a relatively brief behavioral intervention can increase PA among African American men aged 40 years and older living with HIV and potentially curb their risk of NCDs that PA can prevent.
Collapse
Affiliation(s)
- John B. Jemmott
- Annenberg School for Communication, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Loretta S. Jemmott
- College of Nursing and Health Professions, Drexel University, Philadelphia, Pennsylvania, USA
| | - Jingwen Zhang
- Department of Communication and University of California, Davis, Davis, California, USA
- Department of Public Health Sciences, University of California, Davis, Davis, California, USA
| | - Larry D. Icard
- School of Social Work, College of Public Health, Temple University, Philadelphia, Pennsylvania, USA
- Centre for Communication Technologies, School of Information Technology, Nelson Mandela University, Port Elizabeth, South Africa
| | - Terri-Ann Kelly
- School of Nursing, Rutgers University, Camden, New Jersey, USA
| | - Ian Frank
- Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Scarlett L. Bellamy
- Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania, USA
| |
Collapse
|
8
|
Chen C, Finne E, Kopp A, Jekauc D. What Intervention Techniques Are Effective in Changing Positive Affective Variables and Physical Activity? A Systematic Review and Meta-Analysis. Front Psychol 2021; 12:628993. [PMID: 34177690 PMCID: PMC8222822 DOI: 10.3389/fpsyg.2021.628993] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Accepted: 05/14/2021] [Indexed: 12/11/2022] Open
Abstract
A recent meta-analysis has demonstrated that positive affective variables (PAVs) partially mediate physical activity (PA) interventions. However, the effectiveness of each intervention technique on PAVs and PA is still unknown. Thus, this meta-analytic review included two primary objectives: (1) to summarize intervention effects on PA and PAVs; (2) to examine each behavior change technique's effectiveness in modifying PAVs and PA. Following PRISMA protocols, we had searched five electronic databases by April 1, 2020. The random-effect model in the Comprehensive Meta-Analysis Version 3 was adopted to perform these meta-analytic analyses. The search identified 1,742 articles, and 37 studies (49 datasets) met our inclusion criteria. Finally, inferential statistics yielded that: the utilization of "teach to use prompts/cues," "facilitate social comparison," and "provide information on consequences of behavior in general" had positive effects on PA or PAVs outcomes; the utilization of "barrier identification/problem solving" and "plan social support/social change" negatively affected on PA or PAVs outcomes. However, there was considerable heterogeneity in the findings. Nonetheless, this paper has considerable implications for guiding future comparative intervention studies to achieve more reliable outcomes.
Collapse
Affiliation(s)
- Cheng Chen
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology (KIT), Karlsruhe, Germany
| | - Emily Finne
- Department Prevention and Health Promotion, School of Public Health, Bielefeld University, Bielefeld, Germany
| | - Alexandra Kopp
- Department of Sport Science, Institute of Sport Sciences, Humboldt University of Berlin, Berlin, Germany
| | - Darko Jekauc
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology (KIT), Karlsruhe, Germany
| |
Collapse
|
9
|
Erlandson KM, Piggott DA. Frailty and HIV: Moving from Characterization to Intervention. Curr HIV/AIDS Rep 2021; 18:157-175. [PMID: 33817767 PMCID: PMC8193917 DOI: 10.1007/s11904-021-00554-1] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/22/2021] [Indexed: 12/12/2022]
Abstract
PURPOSE OF REVIEW While the characteristics associated with frailty in people with HIV (PWH) have been well described, little is known regarding interventions to slow or reverse frailty. Here we review interventions to prevent or treat frailty in the general population and in people with HIV (PWH). RECENT FINDINGS Frailty interventions have primarily relied on nonpharmacologic interventions (e.g., exercise and nutrition). Although few have addressed frailty, many of these therapies have shown benefit on components of frailty including gait speed, strength, and low activity among PWH. When nonpharmacologic interventions are insufficient, pharmacologic interventions may be necessary. Many interventions have been tested in preclinical models, but few have been tested or shown benefit among older adults with or without HIV. Ultimately, pharmacologic and nonpharmacologic interventions have the potential to improve vulnerability that underlies frailty in PWH, though clinical data is currently sparse.
Collapse
Affiliation(s)
- Kristine M Erlandson
- Department of Medicine, Division of Infectious Diseases, University of Colorado-Anschutz Medical Campus, 12700 E. 19th Avenue, Mail Stop B168, Aurora, CO, 80045, USA.
- Department of Epidemiology, Colorado School of Public Health, Anschutz Medical Campus, Aurora, CO, USA.
| | - Damani A Piggott
- Department of Medicine, Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Department of Epidemiology, Johns Hopkins University School of Public Health, Baltimore, MD, USA
| |
Collapse
|
10
|
Martela F, Hankonen N, Ryan RM, Vansteenkiste M. Motivating voluntary compliance to behavioural restrictions: Self-determination theory–based checklist of principles for COVID-19 and other emergency communications. EUROPEAN REVIEW OF SOCIAL PSYCHOLOGY 2021. [DOI: 10.1080/10463283.2020.1857082] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Frank Martela
- Department of Industrial Engineering and Management, Aalto University, Helsinki, 00076, Finland
| | - Nelli Hankonen
- Faculty of Social Sciences, University of Helsinki, Helsinki, 00014, Finland
| | - Richard M. Ryan
- Institute for Positive Psychology and Education, Australian Catholic University, North Sydney, NSW 2060, Australia
| | - Maarten Vansteenkiste
- Department of Developmental, Personality and Social Psychology, Ghent University, Ghent, 9000, Belgium
| |
Collapse
|
11
|
Bhochhibhoya A, Harrison S, Yonce S, Friedman DB, Ghimire PS, Li X. A systematic review of psychosocial interventions for older adults living with HIV. AIDS Care 2020; 33:971-982. [PMID: 33300368 DOI: 10.1080/09540121.2020.1856319] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
The rapidly growing segment of older adults living with HIV faces unique set of psychosocial challenges that may differ from their younger counterparts. The objective of this review is to systematically examine current published literature on interventions designed to improve the psychosocial wellbeing of older adults living with HIV. A pre-specified search strategy was applied to four databases: PubMed, CINAHL Plus with Text, PsycINFO, and Health Source. Authors reviewed published studies on psychosocial interventions for older adults with HIV and reported psychosocial variables as primary outcomes of the interventions. The final review included nine intervention studies. Psychosocial outcomes measured across multiple studies included depression, quality of life, social support, cognitive functioning, and coping skills. Some studies also measured physical activity, HIV-related discrimination, lack of affordable housing, and access to substance abuse treatment. Our study suggests a paucity of psychosocial intervention research on adults aging with HIV. This review suggests that most psychosocial interventions had small to moderate effects in improving the psychosocial wellbeing of older people living with HIV. Findings highlight the need for clinical, community, and home-based interventions to ensure that individuals can achieve a higher quality of life while aging with HIV.
Collapse
Affiliation(s)
| | - Sayward Harrison
- Department of Psychology, University of South Carolina, Columbia, SC, USA
| | | | - Daniela B Friedman
- Department of Health Promotion, Education, and Behavior, University of South Carolina, Columbia, SC, USA
| | - Pragya Sharma Ghimire
- Department of Physical Education and Exercise Science, Lander University, Greenwood, SC, USA
| | - Xiaoming Li
- Department of Health Promotion, Education, and Behavior, University of South Carolina, Columbia, SC, USA
| |
Collapse
|
12
|
Effects of Aerobic and Resistance Exercise on Cardiovascular Parameters for People Living With HIV: A Meta-analysis. J Assoc Nurses AIDS Care 2020; 30:186-205. [PMID: 30822291 DOI: 10.1097/jnc.0000000000000006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
People living with HIV (PLWH) have limited exercise capacity because of anemia, neuromuscular disorders, and pulmonary limitations. We used a meta-analysis to examine the effect of aerobic and resistance exercise alone and in combination on cardiovascular parameters. Subgroup meta-analyses were conducted and long-term effects of exercise were investigated. A systematic literature search was conducted up to July/August 2017. The Physiotherapy Evidence Database-scale was used to rate quality and assess the risk of bias on the papers. Standardized mean differences (SMDs) were calculated to assess the effect of exercise. Posttreatment comparison between the exercise and control groups revealed moderate and large effect sizes in favor of the intervention group for VO2max (SMD = 0.66, p < .0001) and the 6-minute walk test (SMD = 1.11, p = .0001). Exercise had a positive effect on cardiovascular parameters in PLWH. Exercise can be a prevention factor for PLWH dealing with multiple comorbidities.
Collapse
|
13
|
DiVita MA, Mix JM, Shelly S, Beshers S. Characterization of inpatient rehabilitation outcomes among HIV/AIDS patients: a retrospective cohort study. AIDS Care 2020; 32:1363-1371. [PMID: 32308024 DOI: 10.1080/09540121.2020.1752889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
ABSTRACT Survival time in HIV/AIDS patients has increased as a result of improved treatments, but many acquire functional impairments that may necessitate multidisciplinary medical rehabilitation. In the United States, inpatient rehabilitation facilities (IRF) provide this care, but outcomes are not well described in this population. We used the Uniform Data System for Medical Rehabilitation (UDSMR) database to describe 11,051 HIV/AIDS IRF patients; HIV/AIDS patients were grouped according to the following admission criteria: (1) HIV/AIDS as primary reason for admission (n = 225); (2) HIV/AIDS symptomatic comorbidity (n = 6569); and (3) HIV/AIDS asymptomatic comorbidity (n = 4257). We used standard descriptive statistics to summarize demographic, medical, rehabilitation, and discharge setting characteristics by group. When compared to patients with HIV/AIDS as a comorbidity, primary HIV/AIDS patients had worse outcomes. They made less functional change (25.1 versus 29.8 and 28.9, p < .001), went home less (73.8% versus 74.5% and 77.8%, p < .001) and to an acute care hospital more frequently (18.2% versus 13.9% and 10.1%, p < .001). These findings help to characterize the HIV/AIDS patient population who receive inpatient medical rehabilitation, which helps inform clinical care, and highlight the positive impact IRF care can make to minimize functional disability among chronic HIV/AIDS patients and possibly decrease costs of home health care.
Collapse
Affiliation(s)
- Margaret A DiVita
- Health Department, State University of New York at Cortland, Cortland, NY, USA
| | - Jacqueline M Mix
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, USA
| | - Sandeep Shelly
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, USA
| | - Sarah Beshers
- Health Department, State University of New York at Cortland, Cortland, NY, USA
| |
Collapse
|
14
|
Hidrus A, Kueh YC, Norsaádah B, Chang YK, Hung TM, Naing NN, Kuan G. Effects of Brain Breaks Videos on the Motives for the Physical Activity of Malaysians with Type-2 Diabetes Mellitus. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17072507. [PMID: 32268601 PMCID: PMC7177668 DOI: 10.3390/ijerph17072507] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Revised: 04/01/2020] [Accepted: 04/03/2020] [Indexed: 12/14/2022]
Abstract
Brain Breaks videos are web-based structured physical activity (PA) videos that aim at stimulating an interest in learning and promoting health. Exercise is one of the important treatment regimens for people with type 2 diabetes mellitus (T2DM). Thus, the objective of this study was to determine the effects that Brain Breaks videos have on the motives for PA, as measured by the Physical Activity and Leisure Motivation Scale-Malay (PALMS-M), and the amount of PA, as measured by the International Physical Activity Questionnaire-Malay (IPAQ-M), in T2DM patients (the most common type of diabetes mellitus patients). This study was conducted using a randomized, double-blind design and grouped subjects under two research conditions: an experimental group given Brain Breaks videos and a control group. Purposive sampling was employed to recruit 70 T2DM patients (male = 39, female = 31) with the mean age of 57.6 (SD = 8.5) from Hospital Universiti Sains Malaysia, Kelantan. Over a four-month period, the participants in the experimental group were asked to perform PA daily based on a Brain Breaks video (10 min in duration) that was shared through a WhatsApp group. All participants from both groups answered the PALMS-M questionnaire five times: pre-intervention, the end of the first month, second month, and third month, and post-intervention. A repeated measure multivariate analysis of variance and a repeated measure analysis of variance were performed for the analyses of the data. The results demonstrated that four (appearance, others’ expectations, physical condition, and mastery) out of eight motives for PA produced a significant mean score difference between the two study groups. All eight motives for PA showed an upward trend for the experimental group during the study period, while the control group showed a downward trend for all motives during the study period. As for the amount of PA, both groups showed significant differences (p = 0.001). The amount of PA increased in the experimental group during the study period, while it decreased in the control group. Therefore, Brain Breaks videos can be considered as an effective intervention for motivating T2DM patients for PA and improving their amount of PA.
Collapse
Affiliation(s)
- Aizuddin Hidrus
- Unit of Biostatistics and Research Methodology, School of Medical Sciences, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia; (A.H.); (B.N.)
- Community and Family Medicine Department, Faculty of Medicine and Health Science, Universiti Malaysia Sabah, 88400 Kota Kinabalu, Malaysia
| | - Yee Cheng Kueh
- Unit of Biostatistics and Research Methodology, School of Medical Sciences, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia; (A.H.); (B.N.)
- Correspondence: (Y.C.K.); (G.K.)
| | - Bachok Norsaádah
- Unit of Biostatistics and Research Methodology, School of Medical Sciences, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia; (A.H.); (B.N.)
| | - Yu-Kai Chang
- Department of Physical Education, National Taiwan Normal University, Taipei 24449, Taiwan; (Y.-K.C.); (T.-M.H.)
- Institute of Research Excellence in Learning Science, National Taiwan Normal University, Taipei 24449, Taiwan
| | - Tsung-Min Hung
- Department of Physical Education, National Taiwan Normal University, Taipei 24449, Taiwan; (Y.-K.C.); (T.-M.H.)
- Institute of Research Excellence in Learning Science, National Taiwan Normal University, Taipei 24449, Taiwan
| | - Nyi Nyi Naing
- Faculty of Medicine, Universiti Sultan Zainal Abidin, Medical Campus, Jalan Sultan Mahmud, 20400 Kuala Terengganu, Terengganu, Malaysia;
| | - Garry Kuan
- Exercise and Sports Science Programme, School of Health Sciences, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia
- Department of Life Sciences, Brunel University, London UB8 3PH, UK
- Correspondence: (Y.C.K.); (G.K.)
| |
Collapse
|
15
|
Wing RR, Becofsky K, Wing EJ, McCaffery J, Boudreau M, Evans EW, Unick J. Behavioral and Cardiovascular Effects of a Behavioral Weight Loss Program for People Living with HIV. AIDS Behav 2020; 24:1032-1041. [PMID: 31004243 DOI: 10.1007/s10461-019-02503-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
We recently reported that a 12-week internet weight loss program produced greater weight losses than education control in overweight/obese people living with HIV (PLWH) (4.4 kg vs 1.0 kg; p < 0.05). This manuscript presents the changes in diet, physical activity, behavioral strategies, and cardio-metabolic parameters. Participants (N = 40; 21 males, 19 females) were randomly assigned to an internet behavioral weight loss (WT LOSS) program or internet education control (CONTROL) and assessed before and after the 12-week program. Compared to CONTROL, the WT LOSS arm reported greater use of behavioral strategies, decreases in intake (- 681 kcal/day; p = 0.002), modest, non-significant, increases in daily steps (+ 1079 steps/day) and improvements on the Healthy Eating Index. There were no significant effects on cardio-metabolic parameters. The study suggests that a behavioral weight loss program increases the use of behavioral strategies and modestly improves dietary intake and physical activity in PLWH. Further studies with larger sample sizes and longer follow-up are needed.Clinical Trials Registration: NCT02421406.
Collapse
Affiliation(s)
- Rena R Wing
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University and The Miriam Hospital, Providence, RI, USA.
- Weight Control and Diabetes Research Center, 196 Richmond Street, Providence, RI, 02903, USA.
| | - Katie Becofsky
- Department of Kinesiology, University of Massachuetts Amherst, Amherst, MA, USA
| | - Edward J Wing
- Department of Medicine, Alpert Medical School of Brown University, Providence, RI, USA
| | - Jeanne McCaffery
- Allied Health Science, University of Connecticut, Storrs, CT, USA
| | | | - E Whitney Evans
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University and The Miriam Hospital, Providence, RI, USA
- Weight Control and Diabetes Research Center, 196 Richmond Street, Providence, RI, 02903, USA
| | - Jessica Unick
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University and The Miriam Hospital, Providence, RI, USA
- Weight Control and Diabetes Research Center, 196 Richmond Street, Providence, RI, 02903, USA
| |
Collapse
|
16
|
Ntoumanis N, Ng JY, Prestwich A, Quested E, Hancox JE, Thøgersen-Ntoumani C, Deci EL, Ryan RM, Lonsdale C, Williams GC. A meta-analysis of self-determination theory-informed intervention studies in the health domain: effects on motivation, health behavior, physical, and psychological health. Health Psychol Rev 2020; 15:214-244. [DOI: 10.1080/17437199.2020.1718529] [Citation(s) in RCA: 120] [Impact Index Per Article: 30.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- Nikos Ntoumanis
- School of Psychology, Curtin University, Perth, Australia
- Physical Activity and Well-Being Group, Curtin University, Perth, Australia
| | - Johan Y.Y. Ng
- Department of Sports Science and Physical Education, Chinese University of Hong Kong, Hong Kong
| | | | - Eleanor Quested
- School of Psychology, Curtin University, Perth, Australia
- Physical Activity and Well-Being Group, Curtin University, Perth, Australia
| | - Jennie E. Hancox
- Division of Primary Care, School of Medicine, University of Nottingham, Nottingham, UK
| | - Cecilie Thøgersen-Ntoumani
- School of Psychology, Curtin University, Perth, Australia
- Physical Activity and Well-Being Group, Curtin University, Perth, Australia
| | - Edward L. Deci
- Department of Psychology, University of Rochester, Rochester, USA
- School of Management, University of South-east Norway, Oslo, Norway
| | - Richard M. Ryan
- Institute for Positive Psychology and Education, Australian Catholic University, Sydney, Australia
| | - Chris Lonsdale
- Institute for Positive Psychology and Education, Australian Catholic University, Sydney, Australia
| | - Geoffrey C. Williams
- Department of Medicine, Psychology, and Psychiatry, Center for Community Health and Prevention, University of Rochester Medical Center, Rochester, USA
| |
Collapse
|
17
|
Sousa CV, Lewis JE, Simoes HG, Campbell CSG, Zaldivar S, Rodriguez A, Woolger J, Konefal J, Tiozzo E. The effectiveness of a community-based exercise program on depression symptoms among people living with HIV. AIDS Care 2020; 33:368-374. [PMID: 31996018 DOI: 10.1080/09540121.2020.1719278] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
HIV is a worldwide public health issue affecting millions of individuals, and people living with HIV (PLWH) are often affected by depression. Nonetheless, exercise can prevent and treat depression among PLWH. The aim of the present study was to investigate the effect of exercise on depression symptoms in PLWH. Using a prospective single-arm trial, a semi-supervised community-based exercise intervention was offered 3 times/week for 12 weeks to PLWH (n = 52; age: 49 ± 6 years; HIV diagnosis: 19 ± 15 years). Participants were divided into compliant (≥1 exercise session/week) and non-compliant (<1 exercise session/week) groups according to their attendance in the intervention. Depression symptoms were assessed using the Beck Depression Inventory (BDI), and the change in BDI from baseline to post-intervention was assessed with an analysis of covariance, adjusted for demographics. The post-intervention BDI score was significantly lower (p = 0.027) for the compliant group compared to the non-compliant group, and the rate of improvement from moderate/severe symptoms of depression to minimal symptoms of depression was four times greater in the compliant group. In conclusion, a community-based exercise program may be effective in reducing depression symptoms among PLWH.
Collapse
Affiliation(s)
- Caio V Sousa
- Department of Psychiatry & Behavioral Sciences, University of Miami Miller School of Medicine, Miami, FL, USA.,Graduate Program in Physical Education, Catholic University of Brasilia, Brasilia, Brazil
| | - John E Lewis
- Department of Psychiatry & Behavioral Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Herbert G Simoes
- Graduate Program in Physical Education, Catholic University of Brasilia, Brasilia, Brazil
| | - Carmen S G Campbell
- Graduate Program in Physical Education, Catholic University of Brasilia, Brasilia, Brazil
| | - Sarah Zaldivar
- Department of Kinesiology and Sport Sciences, University of Miami, Miami, FL, USA
| | - Allan Rodriguez
- Department of Medicine, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Judi Woolger
- Department of Medicine, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Janet Konefal
- Department of Family Medicine & Community Health, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Eduard Tiozzo
- Department of Psychiatry & Behavioral Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
| |
Collapse
|
18
|
Dianatinasab M, Ghahri S, Dianatinasab A, Amanat S, Fararouei M. Effects of Exercise on the Immune Function, Quality of Life, and Mental Health in HIV/AIDS Individuals. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2020; 1228:411-421. [PMID: 32342474 DOI: 10.1007/978-981-15-1792-1_28] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Physical exercise is a common type of planned physical activity in order to enhance or maintain a person's physical fitness. Physical exercise may act as an effective strategy to take control of certain conditions associated with HIV-1 infection. HIV infection and its related treatments not only affect the immune system but also cause several musculoskeletal disorders including pre-sarcopenia or sarcopenia, myalgia, and low bone mineral density. Moderate- to high-intensity aerobic exercise, progressive resistance exercise, or a combination of both is considered as a complementary part of medical care and treatment of HIV-infected individuals. In the present chapter, the results of recent investigations regarding the effects of physical activity on muscle strength and function, mental health, and immune system of HIV infected individuals will be discussed.
Collapse
Affiliation(s)
- Mostafa Dianatinasab
- Department of Epidemiology, Center for Health Related Social and Behavioral Sciences Research, Shahroud University of Medical Sciences, Shahroud, Iran.
| | - Simin Ghahri
- Department of Sport Physiology, Shahrood University of Technology, Shahrood, Iran
| | - Aria Dianatinasab
- Department of Biochemistry, Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Sasan Amanat
- Department of Nutrition, School of Health, Larestan University of Medical Sciences, Larestan, Iran
| | - Mohammad Fararouei
- Faculty of Public Health, Department of Epidemiology, Shiraz University of Medical Sciences, Shiraz, Iran
| |
Collapse
|
19
|
Heissel A, Zech P, Rapp MA, Schuch FB, Lawrence JB, Kangas M, Heinzel S. Effects of exercise on depression and anxiety in persons living with HIV: A meta-analysis. J Psychosom Res 2019; 126:109823. [PMID: 31518734 DOI: 10.1016/j.jpsychores.2019.109823] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Revised: 08/30/2019] [Accepted: 08/31/2019] [Indexed: 02/06/2023]
Abstract
OBJECTIVE The purpose of this systematic review and meta-analysis was to examine the effects of exercise on depression and anxiety in people living with HIV (PLWH), and to evaluate, through subgroup analysis, the effects of exercise type, frequency, supervision by exercise professionals, study quality, and control group conditions on these outcomes. METHOD A literature search was conducted through four electronic databases from inception to February 2019. Considered for inclusion were randomized controlled trials (RCTs) investigating exercise interventions and depression or anxiety as outcomes in people living with HIV (≥ 18 years of age). Ten studies were included (n = 479 participants, 49.67% females at baseline), and the standardized mean difference (SMD) and heterogeneity were calculated using random-effect models. An additional pre-post meta-analysis was also conducted. RESULTS A large effect in favor of exercise when compared to controls was found for depression (SMD = -0.84, 95%CI = [-1.57, -0.11], p = 0.02) and anxiety (SMD = -1.23, 95%CI = [-2.42, -0.04], p = 0.04). Subgroup analyses for depression revealed large effects on depression for aerobic exercise only (SMD = -0.96, 95%CI = [-1.63, -0.30], p = 0.004), a frequency of ≥3 exercise sessions per week (SMD = -1.39, 95%CI = [-2.24, -0.54], p < 0.001), professionally supervised exercise (SMD = -1.40, 95%CI = [-2.46, -0.17], p = 0.03]), and high-quality studies (SMD = -1.31, 95%CI = [-2.46, -0.17], p = 0.02). CONCLUSION Exercise seems to decrease depressive symptoms and anxiety in PLWH, but other larger and high-quality studies are needed to verify these effects.
Collapse
Affiliation(s)
- Andreas Heissel
- Social and Preventive Medicine, Department Exercise and Health Sciences, University of Potsdam, Germany.
| | - Philipp Zech
- Social and Preventive Medicine, Department Exercise and Health Sciences, University of Potsdam, Germany
| | - Michael A Rapp
- Social and Preventive Medicine, Department Exercise and Health Sciences, University of Potsdam, Germany
| | - Felipe B Schuch
- Departamento de métodos e técnicas desportivas, Universidade Federal de Santa Maria, Brazil
| | - Jimmy B Lawrence
- Social and Preventive Medicine, Department Exercise and Health Sciences, University of Potsdam, Germany
| | - Maria Kangas
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, Australia
| | - Stephan Heinzel
- Clinical Psychology and Psychotherapy, Department of Education and Psychology, Freie Universität Berlin, Germany
| |
Collapse
|
20
|
Sookan T, Motala A, Ormsbee M, Antonio J, Magula N, Lalloo U, McKune A. Improvement in Muscular Strength in HIV-Infected Individuals Receiving Antiretroviral Therapy. J Funct Morphol Kinesiol 2019; 4:E66. [PMID: 33467381 PMCID: PMC7739231 DOI: 10.3390/jfmk4030066] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Revised: 09/11/2019] [Accepted: 09/12/2019] [Indexed: 11/29/2022] Open
Abstract
PURPOSE This study investigated (1) the effect of a progressive resistance training (PRT) program and whey protein intake on maximal muscle strength in human immunodeficiency virus (HIV)-infected individuals receiving antiretroviral therapy (ART) and (2) alterations in maximal strength 12 wks after the cessation of PRT with continued supplementation. METHODS Sixty HIV-infected individuals were recruited. Whole body PRT was performed twice weekly for 12 wks. Participants received, in a double-blind placebo controlled manner, either 20 g whey or placebo (maltodextrin) before and immediately after each session. Both PRT groups continued to take either whey protein or placebo for a further 12 wks following the exercise intervention to examine the effects of detraining. RESULTS Forty participants (mean and standard deviation (SD) age 40.8 (±7.7) years, weight 70.8 (±16) kg, body mass index (BMI) 30.9 (±7.2) kg m2); whey protein /PRT (n = 13), placebo/PRT (n = 17), and a control group (n = 10) completed the study. A significant main effect for time occurred for the bench press (p = 0.02), the squat (p < 0.0001), the deadlift (p = 0.001) and the shoulder press (p = 0.02) one-repetition maximum (1RM) in the intervention groups. CONCLUSION The PRT program increased maximal strength regardless of whey protein intake. The detraining period demonstrated minimal strength loss, which is beneficial to this population.
Collapse
Affiliation(s)
- Takshita Sookan
- Biokinetics, Exercise and Leisure Sciences, University of KwaZulu-Natal College of Health Sciences, Durban 4000, KwaZulu Natal, South Africa; (M.O.); (A.M.)
| | - Ayesha Motala
- Department of Diabetes and Endocrinology, University of KwaZulu-Natal College of Health Sciences, Durban 4013, KwaZulu Natal, South Africa;
| | - Michael Ormsbee
- Biokinetics, Exercise and Leisure Sciences, University of KwaZulu-Natal College of Health Sciences, Durban 4000, KwaZulu Natal, South Africa; (M.O.); (A.M.)
- Department of Nutrition, Food, and Exercise Sciences, Florida State University, Tallahassee, FL 32306, USA
| | - Jose Antonio
- Exercise and Sport Science, Nova Southeastern University, Davie FL 33328, USA;
| | - Nombulelo Magula
- Department of Internal Medicine Durban, University of KwaZulu-Natal College of Health Sciences, Durban 4013, KwaZulu Natal, South Africa;
| | - Umesh Lalloo
- Department of Pulmonology Durban, University of KwaZulu-Natal College of Health Sciences, Durban 4013, KwaZulu Natal, South Africa;
| | - Andrew McKune
- Biokinetics, Exercise and Leisure Sciences, University of KwaZulu-Natal College of Health Sciences, Durban 4000, KwaZulu Natal, South Africa; (M.O.); (A.M.)
- Discipline of Sport and Exercise Science, University of Canberra, Canberra 2617, Australia
| |
Collapse
|
21
|
Goulding D, Wilson MP, MaWhinney S, Jankowski CM, Erlandson KM. A supervised exercise intervention fails to improve depressive symptoms and quality of life among sedentary older adults with HIV infection. AIDS Care 2019; 32:714-721. [PMID: 31238710 DOI: 10.1080/09540121.2019.1634788] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Older people living with HIV (PLWH) experience multimorbidity that can negatively impact quality of life (QoL). Exercise can improve physical function, but effects on QoL are not well understood. 32 PLWH and 37 controls aged 50-75 completed 12-weeks of moderate-intensity exercise, then were randomized to moderate or high-intensity for 12 additional weeks. Depressive symptoms (CES-D scores) were significantly greater and QOL (SF-36 mental and physical summary scores) significantly lower among PLWH at baseline (all p < 0.05). PLWH had significantly greater worsening in CES-D scores compared to controls (3.4 [0.7, 6.0]; p = 0.01) between 13and 24 weeks. Mental QoL changed minimally, with no significant difference in changes by serostatus between weeks 0 and 12 or weeks 13 and 24 (p ≤ 0.22). Changes in physical function summary scores were similar by serostatus between 0 and 12 weeks (1.5 [-1.6, 4.6], p = 0.35), but declined significantly more among PLWH between 13 and 24 weeks (-4.1 [-7.2,-1], p = 0.01). Exercise intensity had no significant effect on changes in CES-D or SF-36 summary scores; high-intensity exercise was associated with greater improvements in vitality/fatigue (4.1 [0.8, 7.3], p = 0.02), compared to moderate-intensity. Exercise initiation failed to improve depressive symptoms or QoL among PLWH. Additional interventions may be needed to maximize these patient-reported outcomes among older PLWH initiating an exercise program.
Collapse
|
22
|
Lee B, Howard EP. Physical Activity and Positive Psychological Well-Being Attributes Among U.S. Latino Older Adults. J Gerontol Nurs 2019; 45:44-56. [DOI: 10.3928/00989134-20190426-01] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Accepted: 04/03/2019] [Indexed: 11/20/2022]
|
23
|
Kim HJ, Choo J. [Effects of an Integrated Physical Activity Program for Physically Inactive Workers: Based on the PRECEDE-PROCEED Model]. J Korean Acad Nurs 2019; 48:692-707. [PMID: 30613057 DOI: 10.4040/jkan.2018.48.6.692] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Revised: 11/20/2018] [Accepted: 11/21/2018] [Indexed: 11/09/2022]
Abstract
PURPOSE We aimed to examine the effects of an integrated physical activity (PA) program developed for physically inactive workers on the theoretical basis of the PRECEDE-PROCEED model. METHODS Participants were 268 workers in three departments of L manufacturing unit in South Korea. The three departments were randomly allocated into integration (n=86) (INT), education (n=94) (ED), and control (n=88) (CT) groups. The INT group received self-regulation, support, and policy-environmental strategies of a 12-week integrated PA program, the ED group received self-regulation strategies only, and the CT group did not receive any strategies. After 12 weeks, process evaluation was conducted by using the measures of self-regulation (autonomous vs. controlled regulation), autonomy support, and resource availability; impact evaluation by using PA measures of sitting time, PA expenditure, and compliance; and outcome evaluation by using the measures of cardiometabolic/musculoskeletal health and presenteeism. RESULTS Among process measures, autonomous regulation did not differ by group, but significantly decreased in the CT group (p=.006). Among impact measures, PA compliance significantly increased in the INT group compared to the CT group (p=.003). Among outcome measures, the changes in cardiometabolic/musculoskeletal health and presenteeism did not differ by group; however, systolic blood pressure (p=.012) and a presenteeism variable (p=.041) significantly decreased only in the INT group. CONCLUSION The integrated PA program may have a significant effect on increases in PA compliance and significant tendencies toward improvements in a part of cardiometabolic health and presenteeism for physically inactive workers. Therefore, occupational health nurses may modify and use it as a workplace PA program.
Collapse
Affiliation(s)
- Hye Jin Kim
- College of Nursing, Korea University, Seoul, Korea
| | - Jina Choo
- College of Nursing, Korea University, Seoul, Korea.
| |
Collapse
|
24
|
Safeek RH, Hall KS, Lobelo F, del Rio C, Khoury AL, Wong T, Morey MC, McKellar MS. Low Levels of Physical Activity Among Older Persons Living with HIV/AIDS Are Associated with Poor Physical Function. AIDS Res Hum Retroviruses 2018; 34:929-935. [PMID: 29984584 PMCID: PMC6909688 DOI: 10.1089/aid.2017.0309] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Antiretroviral therapy (ART) has prolonged lives of persons living with HIV/AIDS (PLWHA), resulting in greater incidence of aging-related diseases and disability. Physical activity (PA) is recommended for healthy aging, but little is known about PA in older PLWHA. The purpose of this study was to objectively assess PA levels in older PLWHA and the associations with physical function. Twenty-one PLWHA, ≥50 years old, on ART with undetectable HIV-1 viral loads, wore an accelerometer to assess PA, including number of steps, activity intensity, and energy expenditure over 7 days. A physical function performance battery assessing aerobic capacity, strength, and gait speed was also completed. Average age was 66, and 67% were male. An average of 3,442 (interquartile range: 4,613) steps were walked daily, with 254.9 kcals expended. Participants spent most waking hours (75%) sedentary, with minimal hours (24%) in light-intensity activity. Only 5 min per day (35 min per week), on average, were spent in moderate-to-vigorous physical activity (MVPA). Maximal gait speed and 6-min walk test significantly correlated (p < .05) with all PA outcomes. Usual gait speed significantly correlated with all PA outcomes, except for daily kcals and light-intensity activity. Greater PA was associated with better physical performance, while high sedentary time was associated with poorer performance. To our knowledge, this is the first study to objectively measure PA in older PLWHA. Our findings indicate that older PLWHA accumulate substantial sedentary time. Most (86%) do not achieve recommended MVPA levels. This activity profile was associated with poor physical function. Providers should promote PA among PLWHA.
Collapse
Affiliation(s)
- Rachel H. Safeek
- Center for AIDS Research at Emory University, Emory University School of Medicine, Atlanta, Georgia
| | - Katherine S. Hall
- Division of Geriatrics, Department of Medicine, Duke University Medical Center, Durham, North Carolina
- Claude D. Pepper Older Americans Independence Center, Duke University Medical Center, Durham, North Carolina
- Geriatric Research, Education and Clinical Center, Durham Veterans Affairs Healthcare System, Durham, North Carolina
| | - Felipe Lobelo
- Exercise is Medicine Global Research and Collaboration Center, Emory Rollins School of Public Health, Emory University, Atlanta, Georgia
- Hubert Department of Global Health, Emory Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Carlos del Rio
- Center for AIDS Research at Emory University, Emory University School of Medicine, Atlanta, Georgia
- Hubert Department of Global Health, Emory Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Audrey L. Khoury
- University of North Carolina School of Medicine, Chapel Hill, North Carolina
| | - Tammy Wong
- University of North Carolina School of Medicine, Chapel Hill, North Carolina
| | - Miriam C. Morey
- Division of Geriatrics, Department of Medicine, Duke University Medical Center, Durham, North Carolina
- Claude D. Pepper Older Americans Independence Center, Duke University Medical Center, Durham, North Carolina
- Geriatric Research, Education and Clinical Center, Durham Veterans Affairs Healthcare System, Durham, North Carolina
| | - Mehri S. McKellar
- Claude D. Pepper Older Americans Independence Center, Duke University Medical Center, Durham, North Carolina
- Geriatric Research, Education and Clinical Center, Durham Veterans Affairs Healthcare System, Durham, North Carolina
- Division of Infectious Diseases, Duke University Medical Center, Durham, North Carolina
| |
Collapse
|
25
|
Erlandson KM, MaWhinney S, Wilson M, Gross L, McCandless SA, Campbell TB, Kohrt WM, Schwartz R, Brown TT, Jankowski CM. Physical function improvements with moderate or high-intensity exercise among older adults with or without HIV infection. AIDS 2018; 32:2317-2326. [PMID: 30134299 PMCID: PMC6170687 DOI: 10.1097/qad.0000000000001984] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
OBJECTIVE Whether older people living with HIV (PLWH) can achieve similar functional benefits with exercise as their uninfected peers and the ideal intensity of exercise needed for these benefits are not known. DESIGN Sedentary adults (50-75 years) with or without HIV were recruited for 24 weeks of supervised endurance/resistance exercise. After 12 weeks of moderate-intensity exercise, participants were randomized to continue moderate-intensity or advance to high-intensity exercise for an additional 12 weeks. METHODS Outcomes by serostatus and exercise intensity (moderate, high) were compared using linear and mixed effects regression models and controlled for baseline values or week 12 values. RESULTS A total of 32 PLWH and 37 controls were enrolled; 27 PLWH (12 moderate/15 high) and 29 controls (15 moderate/14 high) completed 24 weeks. PLWH had significantly poorer physical function across nearly all baseline measures. Both groups had significant improvements in all functional measures. From 0 to 12 weeks, PLWH had significantly greater percentage improvements (mean, 95% confidence interval) than controls on VO2 max [5 (0, 10)%]; from 13 to 24 weeks, PLWH had significantly greater percentage improvements on stair climb [-5 (-10, -1)%], and the time to complete a 400-m walk [-3 (-5, -0)%]; all P less than 0.05. An interaction between exercise intensity and HIV serostatus was significant for measures of strength: PLWH randomized to high-intensity gained significantly more strength than moderate-intensity in bench and leg press [6 (0, 12)% and 10 (2, 17)% greater; both P < 0.05]; controls had similar gains regardless of intensity. CONCLUSION Both moderate-intensity and high-intensity exercise resulted in significant improvements in physical function; high-intensity exercise may impart greater strength benefits to PLWH.
Collapse
Affiliation(s)
- Kristine M Erlandson
- Division of Infectious Diseases
- Division of Geriatric Medicine, Department of Medicine, School of Medicine
| | - Samantha MaWhinney
- Department of Biostatistics, School of Public Health, University of Colorado Anschutz Medical Campus, Aurora
| | - Melissa Wilson
- Department of Biostatistics, School of Public Health, University of Colorado Anschutz Medical Campus, Aurora
| | - Lilyana Gross
- Department of Biostatistics, School of Public Health, University of Colorado Anschutz Medical Campus, Aurora
| | - Sean A McCandless
- Division of Infectious Diseases
- Division of Geriatric Medicine, Department of Medicine, School of Medicine
| | | | - Wendy M Kohrt
- Division of Geriatric Medicine, Department of Medicine, School of Medicine
- Eastern Colorado VA Geriatric Research, Education and Clinical Center, Denver, Colorado
| | - Robert Schwartz
- Division of Geriatric Medicine, Department of Medicine, School of Medicine
- Eastern Colorado VA Geriatric Research, Education and Clinical Center, Denver, Colorado
| | - Todd T Brown
- Division of Endocrinology, Diabetes, & Metabolism, Department of Medicine, School of Medicine, Johns Hopkins University, Baltimore, Maryland
| | - Catherine M Jankowski
- College of Nursing, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| |
Collapse
|
26
|
Pérez Chaparro CGA, Zech P, Schuch F, Wolfarth B, Rapp M, Heiβel A. Effects of aerobic and resistance exercise alone or combined on strength and hormone outcomes for people living with HIV. A meta-analysis. PLoS One 2018; 13:e0203384. [PMID: 30180202 PMCID: PMC6122835 DOI: 10.1371/journal.pone.0203384] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Accepted: 08/20/2018] [Indexed: 01/20/2023] Open
Abstract
Background Infection with human immunodeficiency virus (HIV) affects muscle mass, altering independent activities of people living with HIV (PLWH). Resistance training alone (RT) or combined with aerobic exercise (AE) is linked to improved muscle mass and strength maintenance in PLWH. These exercise benefits have been the focus of different meta-analyses, although only a limited number of studies have been identified up to the year 2013/4. An up-to-date systematic review and meta-analysis concerning the effect of RT alone or combined with AE on strength parameters and hormones is of high value, since more and recent studies dealing with these types of exercise in PLWH have been published. Methods Randomized controlled trials evaluating the effects of RT alone, AE alone or the combination of both (AERT) on PLWH was performed through five web-databases up to December 2017. Risk of bias and study quality was attained using the PEDro scale. Weighted mean difference (WMD) from baseline to post-intervention changes was calculated. The I2 statistics for heterogeneity was calculated. Results Thirteen studies reported strength outcomes. Eight studies presented a low risk of bias. The overall change in upper body strength was 19.3 Kg (95% CI: 9.8–28.8, p< 0.001) after AERT and 17.5 Kg (95% CI: 16–19.1, p< 0.001) for RT. Lower body change was 29.4 Kg (95% CI: 18.1–40.8, p< 0.001) after RT and 10.2 Kg (95% CI: 6.7–13.8, p< 0.001) for AERT. Changes were higher after controlling for the risk of bias in upper and lower body strength and for supervised exercise in lower body strength. A significant change towards lower levels of IL-6 was found (-2.4 ng/dl (95% CI: -2.6, -2.1, p< 0.001). Conclusion Both resistance training alone and combined with aerobic exercise showed a positive change when studies with low risk of bias and professional supervision were analyzed, improving upper and, more critically, lower body muscle strength. Also, this study found that exercise had a lowering effect on IL-6 levels in PLWH.
Collapse
Affiliation(s)
- Camilo Germán Alberto Pérez Chaparro
- University Outpatient Clinic–Center for Sports Medicine, Department Sports & Health Sciences, University of Potsdam, Potsdam, Brandenburg, Germany
- * E-mail:
| | - Philipp Zech
- Social and Preventive Medicine, Department Exercise and Health Sciences, University of Potsdam, Potsdam, Brandenburg, Germany
| | - Felipe Schuch
- Post-graduate Program in Health and Human Development, La Salle University, Canoas, RS, Brazil
| | - Bernd Wolfarth
- Department of Sports Sciences, Division of Sports Medicine, Humboldt Universität zu Berlin, Berlin, Germany
| | - Michael Rapp
- Social and Preventive Medicine, Department Exercise and Health Sciences, University of Potsdam, Potsdam, Brandenburg, Germany
| | - Andreas Heiβel
- Social and Preventive Medicine, Department Exercise and Health Sciences, University of Potsdam, Potsdam, Brandenburg, Germany
| |
Collapse
|
27
|
Knight L, Mukumbang FC, Schatz E. Behavioral and cognitive interventions to improve treatment adherence and access to HIV care among older adults in sub-Saharan Africa: an updated systematic review. Syst Rev 2018; 7:114. [PMID: 30071903 PMCID: PMC6090879 DOI: 10.1186/s13643-018-0759-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Accepted: 06/24/2018] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Approximately 14% of Africans infected with HIV are over the age of 50, yet few intervention studies focus on improving access to care, retention in care, and adherence to antiretroviral therapy (ART) in this population. A review of the published literature until 2012, found no relevant ART management and care interventions for older people living with HIV (OPLHIV) in sub-Saharan Africa. The aim of this systematic review is to update the original systematic review of intervention studies on OPLHIV, with a focus on evidence from sub-Saharan Africa. METHODS We conducted a systematic review of the available published literature from 2012 to 2017 to explore behavioral and cognitive interventions addressing access to ART, retention in HIV care and adherence to ART in sub-Saharan Africa that include older adults (50+). We searched three databases (MEDLINE, EMBASE, and Education Resources Information Center) using relevant Medical Subject Headings (MeSH) terms as well as a manual search of the reference lists. No language restrictions were placed. We identified eight articles which were analyzed using content analysis with additional information obtained directly from the corresponding authors. RESULTS AND DISCUSSION There were no studies that exclusively focused on OPLHIV. Three studies referred only to participants being over 18 years and did not specify age categories. Therefore, it is unclear whether these studies actively considered people living with HIV over the age of 50. Although the studies sampled older adults, they lacked sufficient data to draw conclusions about the relevance of the outcomes of this group. CONCLUSIONS These findings underscore the need to increase the evidence-base of which interventions will work for older Africans on ART.
Collapse
Affiliation(s)
- Lucia Knight
- School of Public Health, University of the Western Cape, P Bag X17, Bellville, 7535, South Africa
| | - Ferdinand C Mukumbang
- School of Public Health, University of the Western Cape, P Bag X17, Bellville, 7535, South Africa.
| | - Enid Schatz
- Department of Health Sciences and Department of Women's and Gender Studies, University of Missouri, Columbia, USA
| |
Collapse
|
28
|
Vancampfort D, Stubbs B, Mugisha J. Physical activity and HIV in sub-Saharan Africa: a systematic review of correlates and levels. Afr Health Sci 2018; 18:394-406. [PMID: 30602967 PMCID: PMC6306981 DOI: 10.4314/ahs.v18i2.25] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Background Self-management strategies such as physical activity (PA) can address disability and optimize mental, physical, social and economic outcomes for persons living with HIV (PLWH). Understanding factors that influence PA behavior in PLWH is a first step in order to devise effective interventions. Objective The present review provides a systematic review of the correlates of PA in PLWH in sub-Saharan Africa. Methods Electronic databases were searched till April 2016. Keywords included ‘physical activity’ or ‘exercise’ or ‘sports’ and ‘AIDS’ or ‘HIV’. Results Ten correlates were identified in 6 studies including 1,015 (329♂) PLWH (mean age range=30.5–40.8years). Lower levels of PA were associated with older age (2/2 studies), a lower number of CD4 cells/µl (1/1), a more severe HIV-stage (1/1), a higher HIV load (1/1), the presence of opportunistic infections (1/1) and a higher BMI (1/1). Fisher's exact tests showed there were more significant correlates in objective tools versus subjective self-report (P=0.03). Conclusion The current review shows that participation in PA by PLWH in sub-Saharan Africa is associated with a range of complex factors which should be considered in the daily care of PLWH. This however might require repackaging of the current interventions for PLWH to allow a focus on PA.
Collapse
Affiliation(s)
- Davy Vancampfort
- KU Leuven — University of Leuven, Department of Rehabilitation Sciences, Leuven, Belgium
- KU Leuven — University of Leuven, University Psychiatric Center KU Leuven, Leuven-Kortenberg, Belgium
| | - Brendon Stubbs
- Physiotherapy Department, South London and Maudsley NHS Foundation Trust, London, UK
- Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London, UK
| | - James Mugisha
- Butabika National Referral and Mental Health Hospital, Kampala, Uganda
- Kyambogo University, Kampala, Uganda
| |
Collapse
|
29
|
Vader K, Simonik A, Ellis D, Kesbian D, Leung P, Jachyra P, Carusone SC, O'Brien KK. Perceptions of ‘physical activity’ and ‘exercise’ among people living with HIV: A qualitative study. INTERNATIONAL JOURNAL OF THERAPY AND REHABILITATION 2017. [DOI: 10.12968/ijtr.2017.24.11.473] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Affiliation(s)
- Kyle Vader
- Department of Physical Therapy, University of Toronto, Canada
| | - Alya Simonik
- Department of Physical Therapy, University of Toronto, Canada
| | - Denine Ellis
- Department of Physical Therapy, University of Toronto, Canada
| | - Dirouhi Kesbian
- Department of Physical Therapy, University of Toronto, Canada
| | - Priscilla Leung
- Department of Physical Therapy, University of Toronto, Canada
| | - Patrick Jachyra
- Rehabilitation Sciences Institute, University of Toronto, Canada
| | | | - Kelly K O'Brien
- Department of Physical Therapy; Rehabilitation Sciences Institute; Institute of Health Policy, Management and Evaluation, University of Toronto, Canada
| |
Collapse
|
30
|
Nguyen AL, McNeil CJ, Han SD, Rhodes SD. Risk and protective factors for health-related quality of life among persons aging with HIV. AIDS Care 2017; 30:518-522. [PMID: 28944679 DOI: 10.1080/09540121.2017.1381333] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
For persons living with HIV, health-related quality of life (HRQOL) may be threatened by physical and mental conditions but may be protected by positive psychological traits. We performed an exploratory look at the risk and protective factors for HRQOL in older adults living with HIV. Cross-sectional analyses of baseline data from the Rush Center of Excellence on Disparities in HIV and Aging (CEDHA), a community-based cohort of persons ages ≥50 living with HIV (n = 176) were performed. Analyses examined the relationship between risk/protective factors and two outcomes (i.e., self-reported health status [SRHS] and the healthy days index [HDI]). Having good/excellent health was associated with being a non-smoker (p = 0.002), greater purpose in life (p = 0.006), higher education (p = 0.007), fewer depressive symptoms (p = 0.004), fewer disabilities (p = 0.000), and less loneliness (p = 0.002) in bivariate analyses. Males (p = 0.03) and African Americans/Blacks (p = 0.03) reported higher HDI. Fewer depressive symptoms (p = 0.000), disabilities (p = 0.002), adverse life events (p = 0.0103), and loneliness (p = 0.000) were associated with higher HDI in bivariate analyses. In a logistic regression model, greater purpose in life, fewer disabilities, and being a non-smoker were associated with better SRHS after adjusting for covariates. For African Americans/Blacks, having fewer depressive symptoms and disabilities were associated with higher HDI after adjusting for covariates. Disabilities, depression, smoking status, race/ethnicity, and purpose in life were significantly associated with HRQOL. Findings support the need for research to examine the influence of cultural interpretations of life quality and focus on promoting physical function, smoking cessation, and psychological wellness in persons aging with HIV.
Collapse
Affiliation(s)
- Annie L Nguyen
- a Department of Family Medicine, Keck School of Medicine , University of Southern California , Alhambra , CA , USA
| | - Candice J McNeil
- b Department of Internal Medicine, Section on Infectious Diseases , Wake Forest University Health Sciences , Winston-Salem , NC , USA
| | - S Duke Han
- c Department of Family Medicine, Keck School of Medicine , University of Southern California , Los Angeles , CA , USA
| | - Scott D Rhodes
- b Department of Internal Medicine, Section on Infectious Diseases , Wake Forest University Health Sciences , Winston-Salem , NC , USA.,d Department of Social Sciences and Health Policy, Section on Infectious Diseases , Wake Forest University Health Sciences , Winston-Salem , NC , USA
| |
Collapse
|
31
|
Major health impact of accelerated aging in young HIV-infected individuals on antiretroviral therapy. AIDS 2017; 31:1393-1403. [PMID: 28358731 DOI: 10.1097/qad.0000000000001475] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Aging among HIV-infected individuals on antiretroviral therapy (ART) is a significant clinical challenge; however, studies assessing multidimensional aspects of aging are lacking. We characterized 10 geriatric conditions encompassing multiple functional domains, its health impact and associated risk factors in HIV-infected and age-matched uninfected controls. METHODS HIV-infected individuals were recruited from the outpatient clinic in University Malaya Medical Centre, Malaysia and controls from the community. All participants were aged at least 25 years of age with no acute illness, and HIV-infected individuals were on stable ART. Geriatric conditions were assessed and the burden scored as a composite of geriatric conditions present in an individual (total score = 10). Multivariate regression analysis was performed to determine the risk factors and health impact associated with the burden of geriatric conditions. RESULTS We analyzed data from 336 HIV-infected individuals (total HIV+), of whom 172 were matched for age, sex, and ethnicity with 172 HIV-uninfected controls (matched subset). In the total HIV-positive cohort, median (interquartile range) age was 44 (38-51) years and CD4 T-cell count was 562 (398-737) cells/μl. The burden of geriatric conditions was significantly higher in the HIV-infected group compared with controls (P < 0.001). With an increasing geriatric condition burden, quality-of-life scores were 2.2-times poorer, healthcare use five times greater, and mortality risk scores four times higher in the HIV-infected group compared with matched controls. Both sociobehavioural and HIV-related clinical factors were independently associated with an increasing burden of geriatric condition in HIV. CONCLUSIONS A high burden of geriatric conditions with significant impact on health outcomes, including mortality risk scores are observed among HIV-infected individuals on ART in a resource-limited setting.
Collapse
|
32
|
Majeed Z, van Wijngaarden E, Dolan JG, Shah KN. Depression partially mediated the relationship between basic psychological needs and quality of life among people living with HIV. AIDS Care 2017; 29:1399-1403. [PMID: 28278562 DOI: 10.1080/09540121.2017.1300627] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Few studies have examined the relationship between basic psychological needs (BPN), depression and quality of life (QOL) in people living with HIV (PLWH). This cross-sectional study (N = 65; 37% females, 37% Caucasian, mean age = 55 ± 6 years, mean CD4 count = 668 ± 368 cells/mm3, average duration of HIV = 18 ± 4 years) found that BPN frustration was related with lower QOL. The strength of this relationship was reduced after controlling for depression. This suggests that depression partially mediated the relationship between BPN and QOL. BPN and depression may be specific targets for psychosocial interventions aimed at improving QOL in PLWH to promote successful aging.
Collapse
Affiliation(s)
- Zahraa Majeed
- a Department of Medicine, Division of Geriatrics and Aging , University of Rochester , Rochester , USA
| | - Edwin van Wijngaarden
- b Department of Public Health Sciences, School of Medicine and Dentistry , University of Rochester , Rochester , USA
| | - James G Dolan
- b Department of Public Health Sciences, School of Medicine and Dentistry , University of Rochester , Rochester , USA
| | - Krupa N Shah
- a Department of Medicine, Division of Geriatrics and Aging , University of Rochester , Rochester , USA
| |
Collapse
|
33
|
Wing EJ. HIV and aging. Int J Infect Dis 2016; 53:61-68. [PMID: 27756678 DOI: 10.1016/j.ijid.2016.10.004] [Citation(s) in RCA: 190] [Impact Index Per Article: 23.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2016] [Revised: 08/09/2016] [Accepted: 10/06/2016] [Indexed: 01/03/2023] Open
Abstract
With the wider availability of antiretrovirals, the world's HIV population is aging. More than 10% of the 34.5 million HIV-positive individuals worldwide are over the age of 50 years and the average age continues to increase. In the USA more than 50% of the 1.3 million people with HIV are over 50 years old and by the year 2030 it is estimated that 70% will be over the age of 50 years. Although the life expectancy of HIV-positive people has increased dramatically, it still lags behind that of HIV-negative individuals. There is controversy about whether HIV itself accelerates the aging process. Elevated rates of inflammation seen in people with HIV, even if their viral loads are suppressed and their CD4 counts are preserved, are associated with greater rates of cardiovascular, renal, neurocognitive, oncological, and osteoporotic disease. These conditions increase exponentially in the elderly and will represent a major challenge for HIV patients. In addition, conditions such as geriatric syndromes including frailty are also seen at higher rates. Management of the aging HIV patient includes an emphasis on early diagnosis and treatment, preventative measures for co-morbidities, and avoiding polypharmacy. Finally, the issue of quality of life, prioritization of medical issues, and end of life care become increasingly important as the patient grows older.
Collapse
Affiliation(s)
- Edward J Wing
- The Miriam Hospital, Brown University, 164 Summit Avenue, Providence, RI 02906, USA.
| |
Collapse
|