Neurocognitive SuperAging in Older Adults Living with HIV

Demographic, Neuromedical and Everyday Functioning Correlates

Rowan Saloner, Laura M. Campbell, Vanessa Serrano, Jessica L. Montoya, Elizabeth Pasipanodya, Emily W. Paolillo, Donald Franklin, Ronald J. Ellis, Scott L. Letendre, Ann C. Collier, David B. Clifford, Benjamin Gelman, Christina M. Marra, J. Allen McCutchan, Susan Morgello, Ned Sacktor, Dilip V. Jeste, Igor Grant, Robert K. Heaton, David J. Moore

Research output: Contribution to journalArticle

Abstract

Objectives: Studies of neurocognitively elite older adults, termed SuperAgers, have identified clinical predictors and neurobiological indicators of resilience against age-related neurocognitive decline. Despite rising rates of older persons living with HIV (PLWH), SuperAging (SA) in PLWH remains undefined. We aimed to establish neuropsychological criteria for SA in PLWH and examined clinically relevant correlates of SA. Methods: 734 PLWH and 123 HIV-uninfected participants between 50 and 64 years of age underwent neuropsychological and neuromedical evaluations. SA was defined as demographically corrected (i.e., sex, race/ethnicity, education) global neurocognitive performance within normal range for 25-year-olds. Remaining participants were labeled cognitively normal (CN) or impaired (CI) based on actual age. Chi-square and analysis of variance tests examined HIV group differences on neurocognitive status and demographics. Within PLWH, neurocognitive status differences were tested on HIV disease characteristics, medical comorbidities, and everyday functioning. Multinomial logistic regression explored independent predictors of neurocognitive status. Results: Neurocognitive status rates and demographic characteristics differed between PLWH (SA=17%; CN=38%; CI=45%) and HIV-uninfected participants (SA=35%; CN=55%; CI=11%). In PLWH, neurocognitive groups were comparable on demographic and HIV disease characteristics. Younger age, higher verbal IQ, absence of diabetes, fewer depressive symptoms, and lifetime cannabis use disorder increased likelihood of SA. SA reported increased independence in everyday functioning, employment, and health-related quality of life than non-SA. Conclusions: Despite combined neurological risk of aging and HIV, youthful neurocognitive performance is possible for older PLWH. SA relates to improved real-world functioning and may be better explained by cognitive reserve and maintenance of cardiometabolic and mental health than HIV disease severity. Future research investigating biomarker and lifestyle (e.g., physical activity) correlates of SA may help identify modifiable neuroprotective factors against HIV-related neurobiological aging.

Original languageEnglish (US)
JournalJournal of the International Neuropsychological Society
DOIs
StatePublished - Jan 1 2019

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Demography
HIV
Cognitive Reserve
Cannabis
Life Style
Comorbidity
Analysis of Variance
Mental Health
Reference Values
Biomarkers
Logistic Models
Maintenance
Quality of Life
Exercise
Depression
Education

Keywords

  • Acquired Immunodeficiency Syndrome
  • Cannabis
  • Cognitive decline
  • Cognitive reserve
  • Diabetes
  • Neuropsychology

ASJC Scopus subject areas

  • Neuroscience(all)
  • Clinical Psychology
  • Clinical Neurology
  • Psychiatry and Mental health

Cite this

Neurocognitive SuperAging in Older Adults Living with HIV : Demographic, Neuromedical and Everyday Functioning Correlates. / Saloner, Rowan; Campbell, Laura M.; Serrano, Vanessa; Montoya, Jessica L.; Pasipanodya, Elizabeth; Paolillo, Emily W.; Franklin, Donald; Ellis, Ronald J.; Letendre, Scott L.; Collier, Ann C.; Clifford, David B.; Gelman, Benjamin; Marra, Christina M.; McCutchan, J. Allen; Morgello, Susan; Sacktor, Ned; Jeste, Dilip V.; Grant, Igor; Heaton, Robert K.; Moore, David J.

In: Journal of the International Neuropsychological Society, 01.01.2019.

Research output: Contribution to journalArticle

Saloner, R, Campbell, LM, Serrano, V, Montoya, JL, Pasipanodya, E, Paolillo, EW, Franklin, D, Ellis, RJ, Letendre, SL, Collier, AC, Clifford, DB, Gelman, B, Marra, CM, McCutchan, JA, Morgello, S, Sacktor, N, Jeste, DV, Grant, I, Heaton, RK & Moore, DJ 2019, 'Neurocognitive SuperAging in Older Adults Living with HIV: Demographic, Neuromedical and Everyday Functioning Correlates', Journal of the International Neuropsychological Society. https://doi.org/10.1017/S1355617719000018
Saloner, Rowan ; Campbell, Laura M. ; Serrano, Vanessa ; Montoya, Jessica L. ; Pasipanodya, Elizabeth ; Paolillo, Emily W. ; Franklin, Donald ; Ellis, Ronald J. ; Letendre, Scott L. ; Collier, Ann C. ; Clifford, David B. ; Gelman, Benjamin ; Marra, Christina M. ; McCutchan, J. Allen ; Morgello, Susan ; Sacktor, Ned ; Jeste, Dilip V. ; Grant, Igor ; Heaton, Robert K. ; Moore, David J. / Neurocognitive SuperAging in Older Adults Living with HIV : Demographic, Neuromedical and Everyday Functioning Correlates. In: Journal of the International Neuropsychological Society. 2019.
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abstract = "Objectives: Studies of neurocognitively elite older adults, termed SuperAgers, have identified clinical predictors and neurobiological indicators of resilience against age-related neurocognitive decline. Despite rising rates of older persons living with HIV (PLWH), SuperAging (SA) in PLWH remains undefined. We aimed to establish neuropsychological criteria for SA in PLWH and examined clinically relevant correlates of SA. Methods: 734 PLWH and 123 HIV-uninfected participants between 50 and 64 years of age underwent neuropsychological and neuromedical evaluations. SA was defined as demographically corrected (i.e., sex, race/ethnicity, education) global neurocognitive performance within normal range for 25-year-olds. Remaining participants were labeled cognitively normal (CN) or impaired (CI) based on actual age. Chi-square and analysis of variance tests examined HIV group differences on neurocognitive status and demographics. Within PLWH, neurocognitive status differences were tested on HIV disease characteristics, medical comorbidities, and everyday functioning. Multinomial logistic regression explored independent predictors of neurocognitive status. Results: Neurocognitive status rates and demographic characteristics differed between PLWH (SA=17{\%}; CN=38{\%}; CI=45{\%}) and HIV-uninfected participants (SA=35{\%}; CN=55{\%}; CI=11{\%}). In PLWH, neurocognitive groups were comparable on demographic and HIV disease characteristics. Younger age, higher verbal IQ, absence of diabetes, fewer depressive symptoms, and lifetime cannabis use disorder increased likelihood of SA. SA reported increased independence in everyday functioning, employment, and health-related quality of life than non-SA. Conclusions: Despite combined neurological risk of aging and HIV, youthful neurocognitive performance is possible for older PLWH. SA relates to improved real-world functioning and may be better explained by cognitive reserve and maintenance of cardiometabolic and mental health than HIV disease severity. Future research investigating biomarker and lifestyle (e.g., physical activity) correlates of SA may help identify modifiable neuroprotective factors against HIV-related neurobiological aging.",
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author = "Rowan Saloner and Campbell, {Laura M.} and Vanessa Serrano and Montoya, {Jessica L.} and Elizabeth Pasipanodya and Paolillo, {Emily W.} and Donald Franklin and Ellis, {Ronald J.} and Letendre, {Scott L.} and Collier, {Ann C.} and Clifford, {David B.} and Benjamin Gelman and Marra, {Christina M.} and McCutchan, {J. Allen} and Susan Morgello and Ned Sacktor and Jeste, {Dilip V.} and Igor Grant and Heaton, {Robert K.} and Moore, {David J.}",
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T2 - Demographic, Neuromedical and Everyday Functioning Correlates

AU - Saloner, Rowan

AU - Campbell, Laura M.

AU - Serrano, Vanessa

AU - Montoya, Jessica L.

AU - Pasipanodya, Elizabeth

AU - Paolillo, Emily W.

AU - Franklin, Donald

AU - Ellis, Ronald J.

AU - Letendre, Scott L.

AU - Collier, Ann C.

AU - Clifford, David B.

AU - Gelman, Benjamin

AU - Marra, Christina M.

AU - McCutchan, J. Allen

AU - Morgello, Susan

AU - Sacktor, Ned

AU - Jeste, Dilip V.

AU - Grant, Igor

AU - Heaton, Robert K.

AU - Moore, David J.

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N2 - Objectives: Studies of neurocognitively elite older adults, termed SuperAgers, have identified clinical predictors and neurobiological indicators of resilience against age-related neurocognitive decline. Despite rising rates of older persons living with HIV (PLWH), SuperAging (SA) in PLWH remains undefined. We aimed to establish neuropsychological criteria for SA in PLWH and examined clinically relevant correlates of SA. Methods: 734 PLWH and 123 HIV-uninfected participants between 50 and 64 years of age underwent neuropsychological and neuromedical evaluations. SA was defined as demographically corrected (i.e., sex, race/ethnicity, education) global neurocognitive performance within normal range for 25-year-olds. Remaining participants were labeled cognitively normal (CN) or impaired (CI) based on actual age. Chi-square and analysis of variance tests examined HIV group differences on neurocognitive status and demographics. Within PLWH, neurocognitive status differences were tested on HIV disease characteristics, medical comorbidities, and everyday functioning. Multinomial logistic regression explored independent predictors of neurocognitive status. Results: Neurocognitive status rates and demographic characteristics differed between PLWH (SA=17%; CN=38%; CI=45%) and HIV-uninfected participants (SA=35%; CN=55%; CI=11%). In PLWH, neurocognitive groups were comparable on demographic and HIV disease characteristics. Younger age, higher verbal IQ, absence of diabetes, fewer depressive symptoms, and lifetime cannabis use disorder increased likelihood of SA. SA reported increased independence in everyday functioning, employment, and health-related quality of life than non-SA. Conclusions: Despite combined neurological risk of aging and HIV, youthful neurocognitive performance is possible for older PLWH. SA relates to improved real-world functioning and may be better explained by cognitive reserve and maintenance of cardiometabolic and mental health than HIV disease severity. Future research investigating biomarker and lifestyle (e.g., physical activity) correlates of SA may help identify modifiable neuroprotective factors against HIV-related neurobiological aging.

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