TY - JOUR
T1 - Neurocognitive SuperAging in Older Adults Living with HIV
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 B.
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.
N1 - Publisher Copyright:
© The International Neuropsychological Society 2019.
PY - 2019/5/1
Y1 - 2019/5/1
N2 - 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. (JINS, 2019, 25, 507-519).
AB - 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. (JINS, 2019, 25, 507-519).
KW - Acquired Immunodeficiency Syndrome
KW - Cannabis
KW - Cognitive decline
KW - Cognitive reserve
KW - Diabetes
KW - Neuropsychology
UR - http://www.scopus.com/inward/record.url?scp=85063198900&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85063198900&partnerID=8YFLogxK
U2 - 10.1017/S1355617719000018
DO - 10.1017/S1355617719000018
M3 - Article
C2 - 30890191
AN - SCOPUS:85063198900
SN - 1355-6177
VL - 25
SP - 507
EP - 519
JO - Journal of the International Neuropsychological Society
JF - Journal of the International Neuropsychological Society
IS - 5
ER -