title: Lower Frailty Is Associated with Successful Cognitive Aging Among Older Adults with HIV.
abstract: Aging with HIV poses unique and complex challenges, including avoidance of neurocognitive disorder. Our objective here is to identify the prevalence and predictors of successful cognitive aging (SCA) in a sample of older adults with HIV. One hundred three HIV-infected individuals aged 50 and older were recruited from the Modena HIV Metabolic Clinic in Italy. Participants were treated with combination antiretroviral therapy for at least 1 year and had suppressed plasma HIV viral load. SCA was defined as the absence of neurocognitive impairment (as defined by deficits in tasks of episodic learning, information processing speed, executive function, and motor skills) depression, and functional impairment (instrumental activities of daily living). In cross-sectional analyses, odds of SCA were assessed in relation to HIV-related clinical data, HIV-Associated Non-AIDS (HANA) conditions, multimorbidity (≥2HANA conditions), and frailty. A frailty index was calculated as the number of deficits present out of 37 health variables. SCA was identified in 38.8% of participants. Despite no differences in average chronologic age between groups, SCA participants had significantly fewer HANA conditions, a lower frailty index, and were less likely to have hypertension. In addition, hypertension (odds ratio [OR] = 0.40, p = .04), multimorbidity (OR = 0.35, p = .05), and frailty (OR = 0.64, p = .04) were significantly associated with odds of SCA. Frailty is associated with the likelihood of SCA in people living with HIV. This defines an opportunity to apply knowledge from geriatric population research to people aging with HIV to better appreciate the complexity of their health status.
authors.affiliation: 1 Department of Medicine, Dalhousie University , Halifax, Canada .
authors.forename: Lindsay M K
authors.initials: LM
authors.lastname: Wallace
authors.affiliation: 2 Department of Medical and Surgical Sciences for Adults and Children, Clinic of Infectious Diseases, University of Modena and Reggio Emilia , Modena, Italy .
authors.forename: Maria
authors.initials: M
authors.lastname: Ferrara
authors.affiliation: 3 Faculty of Medicine, Dalhousie University , Halifax, Canada .
authors.forename: Thomas D
authors.initials: TD
authors.lastname: Brothers
authors.affiliation: 2 Department of Medical and Surgical Sciences for Adults and Children, Clinic of Infectious Diseases, University of Modena and Reggio Emilia , Modena, Italy .
authors.forename: Sara
authors.initials: S
authors.lastname: Garlassi
authors.affiliation: 1 Department of Medicine, Dalhousie University , Halifax, Canada .|4 Department of Community Health & Epidemiology, Dalhousie University , Halifax, Canada .
authors.forename: Susan A
authors.initials: SA
authors.lastname: Kirkland
authors.affiliation: 4 Department of Community Health & Epidemiology, Dalhousie University , Halifax, Canada .
authors.forename: Olga
authors.initials: O
authors.lastname: Theou
authors.affiliation: 2 Department of Medical and Surgical Sciences for Adults and Children, Clinic of Infectious Diseases, University of Modena and Reggio Emilia , Modena, Italy .
authors.forename: Stefano
authors.initials: S
authors.lastname: Zona
authors.affiliation: 2 Department of Medical and Surgical Sciences for Adults and Children, Clinic of Infectious Diseases, University of Modena and Reggio Emilia , Modena, Italy .
authors.forename: Cristina
authors.initials: C
authors.lastname: Mussini
authors.affiliation: 5 Department of Psychiatry, University of California San Diego , San Diego, California.
authors.forename: David
authors.initials: D
authors.lastname: Moore
authors.affiliation: 1 Department of Medicine, Dalhousie University , Halifax, Canada .
authors.forename: Kenneth
authors.initials: K
authors.lastname: Rockwood
authors.affiliation: 2 Department of Medical and Surgical Sciences for Adults and Children, Clinic of Infectious Diseases, University of Modena and Reggio Emilia , Modena, Italy .
authors.forename: Giovanni
authors.initials: G
authors.lastname: Guaraldi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D000066492:Cognitive Aging; D003430:Cross-Sectional Studies; D005260:Female; D000073496:Frailty / Q000453:epidemiology*; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy*; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged
chemical_list: D019380:Anti-HIV Agents
keywords: AIDS dementia; aging; depression; frail elderly; neuropsychological assessment