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Serrano VB, Pasipanodya EC, Montoya JL, Heaton RK, Jeste DV, Moore DJ. Reactivity of Health-Related Quality of Life to Perceived Stress: The Buffering Role of Psychosocial Resources in a Longitudinal Study of Adults with and Without HIV. J Clin Psychol Med Settings 2024; 31:174-185. [PMID: 37204645 PMCID: PMC10924706 DOI: 10.1007/s10880-023-09962-4] [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: 04/25/2023] [Indexed: 05/20/2023]
Abstract
People with HIV now have increased longevity; however, their health-related quality of life (HRQoL) still lags significantly compared to people without HIV. Perceived stress negatively impacts HRQoL, whereas psychosocial resources are linked to better HRQoL. This longitudinal analysis aims to explore the buffering role of psychosocial resources on the relationship between HRQoL and perceived stress. Participants (N = 240) included 142 persons with HIV (PwH) and 98 without HIV, M(SD) = 50.9(8.1) years. Multilevel models over four study years examined longitudinal relationships between HRQoL (outcome) and perceived stress (predictor) and potential moderation by psychosocial resources (personal mastery, social support, and resilience) by HIV serostatus. Among PwH only, personal mastery (p = 0.001), social support (p = 0.015), and resilience (p = 0.029) were associated with an attenuated effect of perceived stress (less negative slopes) for physical HRQoL over time. Bolstering personal mastery, social support, and resilience may have relevance for improving physical well-being among PwH.
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Affiliation(s)
- Vanessa B Serrano
- San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA
| | - Elizabeth C Pasipanodya
- Department of Psychiatry, University of California San Diego, HIV Neurobehavioral Research Program, 220 Dickinson Street, Suite B (8231), San Diego, CA, 92103, USA
| | - Jessica L Montoya
- Department of Psychiatry, University of California San Diego, HIV Neurobehavioral Research Program, 220 Dickinson Street, Suite B (8231), San Diego, CA, 92103, USA
| | - Robert K Heaton
- Department of Psychiatry, University of California San Diego, HIV Neurobehavioral Research Program, 220 Dickinson Street, Suite B (8231), San Diego, CA, 92103, USA
| | - Dilip V Jeste
- Department of Psychiatry, University of California San Diego, HIV Neurobehavioral Research Program, 220 Dickinson Street, Suite B (8231), San Diego, CA, 92103, USA
- Sam and Rose Stein Institute for Research on Aging, University of California San Diego, La Jolla, San Diego, CA, USA
- Department of Neurosciences, University of California San Diego, La Jolla, San Diego, CA, USA
| | - David J Moore
- Department of Psychiatry, University of California San Diego, HIV Neurobehavioral Research Program, 220 Dickinson Street, Suite B (8231), San Diego, CA, 92103, USA.
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Delfel E, Hammond A, Shields GS, Moore DJ, Slavich GM, Thames AD. Psychological grit moderates the relation between lifetime stressor exposure and functional outcomes among HIV-seropositive and HIV-seronegative adults. Stress Health 2023; 39:1058-1071. [PMID: 36997157 PMCID: PMC10544691 DOI: 10.1002/smi.3245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 01/31/2023] [Accepted: 03/25/2023] [Indexed: 04/01/2023]
Abstract
The ability to maintain functional independence throughout the lifespan may be diminished among medically compromised and chronically stressed populations. People living with HIV are more likely to demonstrate functional impairment and report greater exposure to lifetime and chronic stressors than their seronegative counterparts. It is well-known that exposure to stressors and adversity is associated with functional impairment outcomes. However, to our knowledge, no studies have examined how protective factors such as psychological grit mitigate the negative effects of lifetime and chronic stressor exposure on functional impairment, and how this association differs by HIV-status. To address this issue, we studied associations between lifetime and chronic stressor exposure, grit, and functional impairment in 176 African American and non-Hispanic White HIV-seropositive (n = 100) and HIV-seronegative (n = 76) adults, aged 24-85 (M = 57.28, SD = 9.02). As hypothesised, HIV-seropositive status and lower grit, but not lifetime stressor exposure, were independently associated with more functional impairment. Moreover, there was a significant three-way interaction between HIV-status, grit, and lifetime stressor exposure, b = 0.07, p = 0.025, 95% CI [0.009, 0.135]. Specifically, lifetime stressor exposure was related to more functional impairment for HIV-seronegative-but not HIV-seropositive-adults who reported low levels of grit. These findings suggest that the protective effects of grit may differ across populations at risk for functional impairment.
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Affiliation(s)
- Everett Delfel
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, California, USA
- Department of Psychology, California State University, Long Beach, California, USA
| | - Andrea Hammond
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, California, USA
- Department of Psychology, California State University, Long Beach, California, USA
| | - Grant S. Shields
- Department of Psychological Science, University of Arkansas, Fayetteville, Arkansas, USA
| | - David J. Moore
- Department of Psychiatry, University of California San Diego, San Diego, California, USA
| | - George M. Slavich
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, California, USA
| | - April D. Thames
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, California, USA
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Shao H, Li S. A new perspective on HIV: effects of HIV on brain-heart axis. Front Cardiovasc Med 2023; 10:1226782. [PMID: 37600062 PMCID: PMC10436320 DOI: 10.3389/fcvm.2023.1226782] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 07/25/2023] [Indexed: 08/22/2023] Open
Abstract
The human immunodeficiency virus (HIV) infection can cause damage to multiple systems within the body, and the interaction among these various organ systems means that pathological changes in one system can have repercussions on the functions of other systems. However, the current focus of treatment and research on HIV predominantly centers around individual systems without considering the comprehensive relationship among them. The central nervous system (CNS) and cardiovascular system play crucial roles in supporting human life, and their functions are closely intertwined. In this review, we examine the effects of HIV on the CNS, the resulting impact on the cardiovascular system, and the direct damage caused by HIV to the cardiovascular system to provide new perspectives on HIV treatment.
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Affiliation(s)
| | - Sijun Li
- Department of Internal Medicine, The Fourth People's Hospital of Nanning, Nanning, China
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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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Kim S, Won CW. Optimistic orientation and frailty in community-dwelling older adults: Results from KFACS study. Exp Gerontol 2022; 170:111963. [PMID: 36191834 DOI: 10.1016/j.exger.2022.111963] [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: 07/20/2022] [Revised: 08/30/2022] [Accepted: 09/21/2022] [Indexed: 12/29/2022]
Abstract
OBJECTIVES Optimistic orientation is linked to several benefits, including better-coping skills, lower stress levels, and better physical health. This study aimed to identify whether optimistic orientation is associated with physical frailty and whether it is related to each component of physical frailty. METHODS We conducted a cross-sectional analysis of 2019 survey data from the Korean Frailty and Aging Cohort Study, which included 1203 participants aged 70-84 years. Frailty was defined using the Fried frailty phenotype and optimistic orientation was assessed using the Life Orientation Test-Revised. RESULTS Optimistic orientation and frailty were negatively correlated (r = -0.214, p < 0.001). After adjusting for several variables, the relationship between optimistic orientation and physical frailty was only significant in women (odds ratio [OR] = 2.960, 95 % confidence interval [CI]:2 1.375-6.371). Regarding the relationship with the five components of the physical frailty phenotype, the least optimistic women were more exhausted (OR = 1.829, 95 % CI: 1.224-2.732) and weaker (OR = 1.955, 95 % CI: 1.197-3.192) after adjusting for age, body mass index, alcohol consumption, smoking, education, marital status, social activity, living alone, family income, cognitive state, nutritional status, comorbidity, and depression. DISCUSSION Optimistic orientation was negatively associated with physical frailty only in women. Among the components of physical frailty, exhaustion and weakness are associated with optimistic orientation in women.
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Affiliation(s)
- Sunyoung Kim
- Department of Family Medicine, College of Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Chang Won Won
- Elderly Frailty Research Center, Department of Family Medicine, College of Medicine, Kyung Hee University, Seoul, Republic of Korea.
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Li J, Chen X, Lin H, Yuan S, Shi R, Xu L, Qiao S, He C, Shen W, He N, Ding Y. Associations between
HIV
infection and frailty status and its individual components: Are frailty components disproportionally affected? HIV Med 2022; 24:533-543. [PMID: 36288971 DOI: 10.1111/hiv.13429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 10/10/2022] [Indexed: 12/01/2022]
Abstract
OBJECTIVE We aimed to examine whether HIV infection was independently associated with frailty status and its individual components. METHODS This cross-sectional investigation included people living with HIV (PLWH) and HIV-negative individuals from the baseline survey of the Comparative HIV and Aging Research in Taizhou (CHART) cohort, China. Frailty phenotype was based on five components: weight loss, low physical activity, exhaustion, weak grip strength and slow gait speed. Frailty was defined as the presence of at least three components, and prefrailty was defined as one or two components. Logistic regression models were used to analyse the factors associated with frailty and its components. RESULTS In all, 2475 people living with HIV (age 45.5 ± 14.9 years; 76.2% male) and 4948 HIV-negative individuals (age 45.5 ± 14.8 years; 76.3% male) were included. Among PLWH, median CD4 count was 395 cells/μL and 78% were currently on antiretroviral therapy (ART). Frailty and prefrailty were significantly more prevalent in PLWH (3.2% vs 1.9% and 32.9% vs 27.9%) overall and at ages 18-39 (1.4% vs 0.2% and 22.7% vs 19.0%), 40-59 (2.5% vs 0.9% and 30.9% vs 27.9%) and 60-90 years (8.4% vs 7.4% and 57.1% vs 45.8%). HIV infection was associated with frailty and prefrailty [adjusted odds ratio (aOR) = 1.48, 95% confidence interval (CI): 1.06-2.08; and aOR = 1.18, 95% CI: 1.05-1.33, respectively] after adjusting for confounding variables, but were strengthened with further adjustment for multimorbidity (aOR = 1.62, 95% CI: 1.14-2.28; and aOR = 1.22, 95% CI: 1.09-1.37), and were no longer significant with further adjustment for depressive symptoms and sleep disorders (aOR = 1.02, 95% CI: 0.71-1.46; and aOR = 1.06, 95% CI: 0.94-1.20). Among individual components, HIV infection was positively associated with weak grip strength and slow gait speed, but negatively associated with low physical activity and exhaustion in all the adjusted models described. CONCLUSIONS Frailty and prefrailty occur more often and earlier in PLWH. However, grip strength and gait speed are affected to a greater extent, highlighting their potential as screening and intervention targets to prevent or slow frailty among PLWH.
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Affiliation(s)
- Jing Li
- Department of Epidemiology, School of Public Health Fudan University, and The Key Laboratory of Public Health Safety of Ministry of Education Shanghai China
| | - Xiaoxiao Chen
- Taizhou City Center for Disease Control and Prevention Zhejiang China
| | - Haijiang Lin
- Taizhou City Center for Disease Control and Prevention Zhejiang China
| | - Shiying Yuan
- Department of Epidemiology, School of Public Health Fudan University, and The Key Laboratory of Public Health Safety of Ministry of Education Shanghai China
| | - Ruizi Shi
- Department of Epidemiology, School of Public Health Fudan University, and The Key Laboratory of Public Health Safety of Ministry of Education Shanghai China
| | - Lulu Xu
- Department of Epidemiology, School of Public Health Fudan University, and The Key Laboratory of Public Health Safety of Ministry of Education Shanghai China
| | - Shijie Qiao
- Department of Epidemiology, School of Public Health Fudan University, and The Key Laboratory of Public Health Safety of Ministry of Education Shanghai China
| | - Chunyan He
- Department of Epidemiology, School of Public Health Fudan University, and The Key Laboratory of Public Health Safety of Ministry of Education Shanghai China
| | - Weiwei Shen
- Taizhou City Center for Disease Control and Prevention Zhejiang China
| | - Na He
- Department of Epidemiology, School of Public Health Fudan University, and The Key Laboratory of Public Health Safety of Ministry of Education Shanghai China
| | - Yingying Ding
- Department of Epidemiology, School of Public Health Fudan University, and The Key Laboratory of Public Health Safety of Ministry of Education Shanghai China
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Wang Y, Chen Y, Xu J, Chen H, Gao J. Association between resilience and frailty among Chinese older adults. Front Psychiatry 2022; 13:948958. [PMID: 35923449 PMCID: PMC9341387 DOI: 10.3389/fpsyt.2022.948958] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Accepted: 06/27/2022] [Indexed: 12/26/2022] Open
Abstract
PURPOSE Resilience is a multidimensional concept determining healthy aging, however, there were limited studies examining the association between frailty and resilience in detail. In this study, we aimed to examine the association of frailty with three dimensions of resilience-strength, optimism, and tenacity among Chinese older adults. METHODS A cross-sectional study was conducted among 10,209 participants who were sampled by three-stage sampling method, from three cities in China from June 2020 to July 2021. The Chinese version of the Connor-Davidson Resilience Scale (CD-RISC) was used to measure resilience's 3 dimensions (strength, optimism and tenacity), which were converted into quartiles for the analysis. Frailty status was measured using the Chinese version of the FRAIL scale, categorized into robustness, pre-frailty and frailty. Multinomial logistic regression was used to examine associations between frailty status with strength, optimism and tenacity. RESULTS The overall proportions of robustness, pre-frailty, and frailty were 42.7, 48.7, and 8.6%, respectively. After controlling for sociodemographic characteristics, self-rated health, and health behaviors, compared with older adults with the lowest quartile of strength, older adults with the second quartile (odds ratio, OR = 0.67, 95% CI: 0.57-0.78), third quartile (OR = 0.60, 95% CI: 0.50-0.72), and fourth quartile (OR = 0.58, 95% CI: 0.46-0.73) of strength had lower ORs for pre-frailty, and who also had lower ORs (0.44, 95% CI: 0.33-0.58; 0.42, 95% CI: 0.30-0.59; 0.34, 95% CI: 0.20-0.56, respectively) for frailty. There were no homogeneous associations between optimism and tenacity with frailty status. CONCLUSION Higher strength was associated with lower chance of being pre-frail and frail among Chinese older adults. This finding implies that community-based training programs aiming to enhance psychological resilience, especially strength, may contribute to healthy aging. Future studies should examine the effects of resilience on frailty using longitudinal or experimental study designs in cross-cultural contexts.
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Affiliation(s)
- Yujie Wang
- School of Public Health, Fudan University, Shanghai, China
| | - Yingwei Chen
- School of Public Health, Fudan University, Shanghai, China
| | - Jixiang Xu
- School of Public Health, Fudan University, Shanghai, China
| | - Hao Chen
- School of Public Health, Fudan University, Shanghai, China
| | - Junling Gao
- School of Public Health, Fudan University, Shanghai, China.,Collaborative Innovation Cooperative Unit of National Clinical Research Center for Geriatric Diseases, Shanghai, China.,Core Unit of Shanghai Clinical Research Center for Geriatric Diseases, Shanghai, China
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8
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Gianella S, Saloner R, Curtin G, Little SJ, Heaton A, Montoya JL, Letendre SL, Marquine MJ, Jeste DV, Moore DJ. A Cross-Sectional Study to Evaluate the Effects of Age and Duration of HIV Infection on Anxiety and Depression in Cisgender Men. AIDS Behav 2022; 26:196-203. [PMID: 34287757 PMCID: PMC8294268 DOI: 10.1007/s10461-021-03373-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/03/2021] [Indexed: 11/27/2022]
Abstract
This observational cross-sectional study of 152 people with HIV (PWH) examined the effects of age and estimated duration of HIV infection (EDI) on depressive and anxiety symptoms. All participants were cisgender men and completed the Profile of Moods State (POMS), a self-report inventory of current (i.e., past week) mood states. Overall, study results confirmed higher levels of anxiety and depression in PWH compared to individuals without HIV. Age group (< 50 or ≥ 50 years) moderated the effect of EDI (< 3 or ≥ 3 years) on mood disturbance. Specifically, younger PWH with early diagnosed infection exhibited the highest levels of depression and anxiety, whereas depression and anxiety were attenuated in older PWH with early infection such that their POMS scores did not significantly differ from the HIV-negative and chronically HIV-infected groups. Despite the small sample size and other important limitations in our study design, our preliminary findings confirm previous observations that older people may have some adaptive ability to better handle the acute psychological stressors associated with recent HIV infection.
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Affiliation(s)
- Sara Gianella
- Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California San Diego, 9500 Gilman Drive MC 0679, La Jolla, CA, 92093-0679, USA.
| | - Rowan Saloner
- Department of Psychiatry, University of California San Diego, La Jolla, USA
| | - Genevieve Curtin
- Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California San Diego, 9500 Gilman Drive MC 0679, La Jolla, CA, 92093-0679, USA
| | - Susan J Little
- Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California San Diego, 9500 Gilman Drive MC 0679, La Jolla, CA, 92093-0679, USA
| | - Anne Heaton
- Department of Psychiatry, University of California San Diego, La Jolla, USA
| | - Jessica L Montoya
- Department of Psychiatry, University of California San Diego, La Jolla, USA
| | - Scott L Letendre
- Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California San Diego, 9500 Gilman Drive MC 0679, La Jolla, CA, 92093-0679, USA
- Department of Psychiatry, University of California San Diego, La Jolla, USA
| | - María J Marquine
- Division of Geriatrics, Gerontology and Palliative Care, University of California, La Jolla, USA
| | - Dilip V Jeste
- Department of Psychiatry, University of California San Diego, La Jolla, USA
- Sam and Rose Stein Institute for Research on Aging, University of California San Diego, La Jolla, USA
- Department of Neurosciences, University of California San Diego, La Jolla, USA
| | - David J Moore
- Department of Psychiatry, University of California San Diego, La Jolla, USA
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Tan JY, Sheira LA, Frongillo EA, Gustafson D, Sharma A, Merenstein D, Cohen MH, Golub E, Edmonds A, Ofotokun I, Fischl M, Konkle‐Parker D, Neilands T, Tien P, Weiser SD. Food insecurity and frailty among women with and without HIV in the United States: a cross-sectional analysis. J Int AIDS Soc 2021; 24:e25751. [PMID: 34128343 PMCID: PMC8204023 DOI: 10.1002/jia2.25751] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 04/28/2021] [Accepted: 05/05/2021] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION Frailty is frequently observed among people with HIV, and food insecurity is associated with frailty in the general population. Evidence is scarce on the associations between food insecurity and frailty among women with HIV who may be particularly vulnerable to the impacts of food insecurity. The goal of this study was to assess associations between food insecurity and frailty among women with and without HIV. METHODS There were 1265 participants from the Women's Interagency HIV Study who participated in frailty assessments in 2017. Frailty was measured using the Fried Frailty Phenotype, and women were subsequently categorized as robust, pre-frail or frail. Food insecurity was assessed using the U.S. Household Food Security Survey Module, with women categorized as having high, marginal, low or very low food security. Multinomial logistic regression models were conducted to examine cross-sectional associations between food insecurity and frailty while adjusting for socio-demographic, behavioural and HIV status covariates. RESULTS AND DISCUSSION Approximately one-third (31.9%) of the women had marginal, low or very low food security, and the proportions of women who met the criteria for frailty or pre-frailty were 55.6% and 12.4% respectively. In the adjusted model, the relative risk ratio (RRR) of frailty for women with very low food security versus women with high food security was 3.37 (95% CI [1.38 to 8.24], p < 0.01); the corresponding RRR of pre-frailty was 3.63 (95% CI [1.76 to 7.51], p < 0.001). Higher annual household income was associated with lower RRRs of frailty or pre-frailty (p < 0.01). Similarly, older age was associated with more frequent frailty (RRR=1.06, 95% CI [1.03 to 1.09], p < 0.001). HIV serostatus was not significantly associated with either pre-frailty (RRR=0.97, 95% CI [0.71 to 1.31]) or frailty (RRR=0.75, 95% CI [0.48 to 1.16]). CONCLUSIONS Very low food security was associated with more frequent frailty and pre-frailty among women with and without for HIV. HIV serostatus was not associated with frailty.
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Affiliation(s)
- Judy Y Tan
- Center for AIDS Prevention StudiesUniversity of CaliforniaSan Francisco (UCSF)San FranciscoCAUSA
| | - Lila A Sheira
- Division of HIV, ID and Global MedicineUniversity of CaliforniaSan Francisco (UCSF)San FranciscoCAUSA
| | - Edward A Frongillo
- Department of Health Promotion, Education, and BehaviorUniversity of South CarolinaColumbiaSCUSA
| | - Deborah Gustafson
- Department of NeurologyState University of New York Downstate Health Sciences UniversityBrooklynNYUSA
| | - Anjali Sharma
- Department of MedicineAlbert Einstein College of MedicineBronxNYUSA
| | - Daniel Merenstein
- Department of Family MedicineGeorgetown University Medical CenterWashingtonDCUSA
| | - Mardge H Cohen
- Department of MedicineStroger Hospital of Cook County HealthChicagoILUSA
| | - Elizabeth Golub
- WIHS Data Management CenterBloomberg School of Public HealthDepartment of EpidemiologyJohns Hopkins UniversityBaltimoreMDUSA
| | - Andrew Edmonds
- Department of EpidemiologyGillings School of Global Public HealthUniversity of North Carolina at Chapel HillChapel HillNCUSA
| | - Igho Ofotokun
- School of MedicineDepartment of MedicineEmory UniversityAtlantaGAUSA
- Grady Healthcare SystemAtlantaGAUSA
| | - Margaret Fischl
- Miller School of MedicineUniversity of MiamiCoral GablesFLUSA
| | - Deborah Konkle‐Parker
- Department of Medicine/Division of Infectious DiseasesSchool of NursingSchool of Population Health SciencesUniversity of Mississippi Medical CenterJacksonMSUSA
| | - Torsten Neilands
- Center for AIDS Prevention StudiesUniversity of CaliforniaSan Francisco (UCSF)San FranciscoCAUSA
| | - Phyllis Tien
- Department of MedicineSan Francisco and Medical ServiceDepartment of Veteran Affairs Medical CenterUniversity of CaliforniaSan FranciscoCAUSA
| | - Sheri D Weiser
- Center for AIDS Prevention StudiesUniversity of CaliforniaSan Francisco (UCSF)San FranciscoCAUSA
- Division of HIV, ID and Global MedicineUniversity of CaliforniaSan Francisco (UCSF)San FranciscoCAUSA
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10
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Qrareya AN, Mahdi F, Kaufman MJ, Ashpole NM, Paris JJ. HIV-1 Tat promotes age-related cognitive, anxiety-like, and antinociceptive impairments in female mice that are moderated by aging and endocrine status. GeroScience 2021; 43:309-327. [PMID: 32940828 PMCID: PMC8050151 DOI: 10.1007/s11357-020-00268-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Accepted: 09/10/2020] [Indexed: 12/15/2022] Open
Abstract
Hypogonadism is a common comorbidity associated with HIV-1 that is more prevalent among infected individuals over the age of 45. The underlying mechanisms are unknown, but both combined antiretroviral therapeutics and HIV-1 proteins, such as trans-activator of transcription protein (Tat), dysregulate steroid-synthetic mechanisms including lipid storage/synthesis and mitochondrial function. Thus, Tat expression may accelerate age-related comorbidities partly by impairing endocrine function. Few studies exist of Tat-mediated behavioral deficits in aged animals and effects of endocrine status have not been investigated. Accordingly, we tested whether conditional Tat expression in aged (~ 1.5 years old), female, Tat-transgenic [Tat(+)] mice increases anxiety-like behavior, impairs cognition, and augments mechanical allodynia, when compared to age-matched controls that do not express Tat protein [Tat(-)]. We further tested whether aged mice that maintained their endocrine status (pre-estropausal) were more resilient to Tat/age-related comorbidities than peri- or post-estropausal mice. Tat and endocrine aging status exerted separate and interacting effects that influenced anxiety-like and cognitive behaviors. Peri- and post-estropausal mice exhibited greater anxiety-like behavior in the elevated plus-maze and impaired learning in the radial arm water maze compared to pre-estropausal mice. Irrespective of estropause status, Tat(+) mice demonstrated impaired learning, reduced grip strength, and mechanical allodynia compared to Tat(-) mice. Tat exposure reduced circulating estradiol in post-estropausal mice and increased the estradiol-to-testosterone ratio in pre-estropausal mice. Changes in circulating estradiol, testosterone, and progesterone correlated with grip strength. Thus, endocrine status is an important factor in age-related anxiety, cognition, neuromuscular function, and allodynia that can be accelerated by HIV-1 Tat protein.
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Affiliation(s)
- Alaa N Qrareya
- Department of BioMolecular Sciences, School of Pharmacy, University of Mississippi, 315 Faser Hall, P.O. Box 1848, University, MS, 38677-1848, USA
| | - Fakhri Mahdi
- Department of BioMolecular Sciences, School of Pharmacy, University of Mississippi, 315 Faser Hall, P.O. Box 1848, University, MS, 38677-1848, USA
| | - Marc J Kaufman
- Department of Psychiatry, McLean Imaging Center, McLean Hospital/Harvard Medical School, Belmont, MA, 02478, USA
| | - Nicole M Ashpole
- Department of BioMolecular Sciences, School of Pharmacy, University of Mississippi, 315 Faser Hall, P.O. Box 1848, University, MS, 38677-1848, USA
- Research Institute of Pharmaceutical Sciences, University of Mississippi, University, MS, 38677, USA
| | - Jason J Paris
- Department of BioMolecular Sciences, School of Pharmacy, University of Mississippi, 315 Faser Hall, P.O. Box 1848, University, MS, 38677-1848, USA.
- Research Institute of Pharmaceutical Sciences, University of Mississippi, University, MS, 38677, USA.
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11
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Sardella A, Lenzo V, Bonanno GA, Martino G, Basile G, Quattropani MC. Dispositional Optimism and Context Sensitivity: Psychological Contributors to Frailty Status Among Elderly Outpatients. Front Psychol 2021; 11:621013. [PMID: 33519646 PMCID: PMC7838363 DOI: 10.3389/fpsyg.2020.621013] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2020] [Accepted: 12/16/2020] [Indexed: 12/24/2022] Open
Abstract
The association of resilience-related factors with frailty is a recent research topic. Dispositional optimism and context sensitivity are two psychological factors that differently contribute to individual resilience. This study aimed at investigating whether dispositional optimism and context sensitivity might contribute to a multifactorial model of frailty, together with established relevant factors such as cognitive and physical factors. This cross-sectional study involved 141 elderly outpatients (42 males and 99 females) aged ≥65 years, who were referred to the Geriatrics and Multidimensional Evaluation Clinic of the University Hospital of Messina. We used the following measures: the Mini-Mental State Examination (MMSE) to screen for global cognitive functioning; 4-m gait speed and handgrip strength to measure physical performance; a 35-item Frailty Index (FI) to evaluate patients’ frailty status; the revised Life Orientation Test (LOT-R) to gauge dispositional optimism; and the Context Sensitivity Index (CSI) to measure context sensitivity. We found that LOT-R (β = −0.190, p = 0.038), CSI (β = −0.191, p = 0.035), and MMSE (β = −0.466, p < 0.001) were all significantly associated with FI. Gait speed was only marginally associated with FI (β = −0.184, p = 0.053). The present study showed a novel association of dispositional optimism and context sensitivity with frailty among elderly outpatients. These preliminary findings support a multidimensional approach to frailty in which even peculiar psychological features might provide a significant contribution.
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Affiliation(s)
- Alberto Sardella
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Vittorio Lenzo
- Department of Social and Educational Sciences of the Mediterranean Area, University for Foreigners "Dante Alighieri" of Reggio Calabria, Reggio Calabria, Italy
| | - George A Bonanno
- Department of Clinical Psychology, Teachers College, Columbia University, New York, NY, United States
| | - Gabriella Martino
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Giorgio Basile
- School and Unit of Geriatrics, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Maria C Quattropani
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
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12
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Paolillo EW, Sun-Suslow N, Pasipanodya EC, Morgan EE, Ellis RJ, Jeste DV, Moore DJ. Pre-frailty predicts cognitive decline at 2-year follow-up in persons living with HIV. J Neurovirol 2020; 26:168-180. [PMID: 31858484 PMCID: PMC7391910 DOI: 10.1007/s13365-019-00814-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Revised: 10/04/2019] [Accepted: 11/06/2019] [Indexed: 12/12/2022]
Abstract
Both HIV disease and frailty syndrome are risk factors for neurocognitive impairment. Longitudinal research among individuals of the general population suggests that frailty predicts future cognitive decline; however, there is limited evidence for these longitudinal relationships among people living with HIV (PLWH). The current study evaluated and compared rates of cognitive decline over 2 years among HIV serostatus and frailty status groups. Participants included 50 PLWH and 60 HIV-uninfected (HIV-) participants who were evaluated at baseline and 2-year follow-up visits. Baseline frailty status (non-frail, pre-frail, and frail) was determined using fried frailty phenotype criteria. Neurocognitive functioning was measured using practice-effect corrected scaled scores derived from a comprehensive neuropsychological battery covering seven cognitive domains. Repeated measures analysis was used to estimate rates of global and domain-specific cognitive change from baseline to 2-year follow-up among each of six HIV/frailty status groups. Among PLWH, the pre-frail group demonstrated consistent declines in global cognitive functioning (B = - 0.029, p = 0.034), processing speed (B = - 0.047, p = 0.031), and motor functioning (B = - 0.048, p = 0.038). Among HIV- participants, pre-frail individuals also declined in global cognitive functioning and processing speed (ps ≤ 0.05). HIV- non-frail participants also declined in the cognitive domains of learning, delayed recall, and motor functioning; however, these declines appeared to be driven by relatively higher baseline scores among this group. Notably, 38% of PLWH changed in frailty status from baseline to follow-up, and those with stable pre-frailty demonstrated higher likelihood for cognitive decline; change in depressive symptoms did not relate to change in frailty status. Current findings highlight pre-frailty as an important clinical syndrome that may be predictive of cognitive decline among PLWH. Interventions to prevent or reduce frailty among vulnerable PLWH are needed to maintain optimal cognitive health.
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Affiliation(s)
- Emily W Paolillo
- San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA
- Department of Psychiatry, University of California San Diego, San Diego, CA, 92103-8231, USA
| | - Ni Sun-Suslow
- Department of Psychiatry, University of California San Diego, San Diego, CA, 92103-8231, USA
| | | | - Erin E Morgan
- Department of Psychiatry, University of California San Diego, San Diego, CA, 92103-8231, USA
| | - Ronald J Ellis
- Department of Neurosciences, University of California, San Diego, CA, USA
| | - Dilip V Jeste
- Department of Psychiatry, University of California San Diego, San Diego, CA, 92103-8231, USA
- Sam and Rose Stein Institute for Research on Aging, University of California San Diego, San Diego, CA, USA
| | - David J Moore
- Department of Psychiatry, University of California San Diego, San Diego, CA, 92103-8231, USA.
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13
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Fields JA, Ellis RJ. HIV in the cART era and the mitochondrial: immune interface in the CNS. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2019; 145:29-65. [PMID: 31208526 DOI: 10.1016/bs.irn.2019.04.003] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
HIV-associated neurocognitive disorders (HAND) persist in the era of effective combined antiretroviral therapy (cART). A large body of literature suggests that mitochondrial dysfunction is a prospective etiology of HAND in the cART era. While viral load is often suppressed and the immune system remains intact in HIV+ patients on cART, evidence suggests that the central nervous system (CNS) acts as a reservoir for virus and low-level expression of viral proteins, which interact with mitochondria. In particular, the HIV proteins glycoprotein 120, transactivator of transcription, viral protein R, and negative factor have each been linked to mitochondrial dysfunction in the brain. Moreover, cART drugs have also been shown to have detrimental effects on mitochondrial function. Here, we review the evidence generated from human studies, animal models, and in vitro models that support a role for HIV proteins and/or cART drugs in altered production of adenosine triphosphate, mitochondrial dynamics, mitophagy, calcium signaling and apoptosis, oxidative stress, mitochondrial biogenesis, and immunometabolism in the CNS. When insightful, evidence of HIV or cART-induced mitochondrial dysfunction in the peripheral nervous system or other cell types is discussed. Lastly, therapeutic approaches to targeting mitochondrial dysfunction have been summarized with the aim of guiding new investigations and providing hope that mitochondrial-based drugs may provide relief for those suffering with HAND.
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Affiliation(s)
- Jerel Adam Fields
- Department of Psychiatry, University of California San Diego, La Jolla, CA, United States.
| | - Ronald J Ellis
- Department of Neuroscience, University of California San Diego, La Jolla, CA, United States
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