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Neurocognitive SuperAging in Older Adults Living With HIV: Demographic, Neuromedical and Everyday Functioning Correlates

Published online by Cambridge University Press:  20 March 2019

Rowan Saloner ,
Laura M. Campbell ,
Vanessa Serrano ,
Jessica L. Montoya ,
Elizabeth Pasipanodya ,
Emily W. Paolillo ,
Donald Franklin ,
Ronald J. Ellis ,
Scott L. Letendre  and
Ann C. Collier
...Show all authors
Rowan Saloner
Affiliation:
San Diego State University/University of California, San Diego Joint Doctoral Program in Clinical Psychology, San Diego, California Department of Psychiatry, University of California, San Diego, San Diego, California
Laura M. Campbell
Affiliation:
San Diego State University/University of California, San Diego Joint Doctoral Program in Clinical Psychology, San Diego, California Department of Psychiatry, University of California, San Diego, San Diego, California
Vanessa Serrano
Affiliation:
Department of Psychiatry, University of California, San Diego, San Diego, California
Jessica L. Montoya
Affiliation:
Department of Psychiatry, University of California, San Diego, San Diego, California
Elizabeth Pasipanodya
Affiliation:
Department of Psychiatry, University of California, San Diego, San Diego, California
Emily W. Paolillo
Affiliation:
San Diego State University/University of California, San Diego Joint Doctoral Program in Clinical Psychology, San Diego, California Department of Psychiatry, University of California, San Diego, San Diego, California
Donald Franklin
Affiliation:
Department of Psychiatry, University of California, San Diego, San Diego, California
Ronald J. Ellis
Affiliation:
Department of Psychiatry, University of California, San Diego, San Diego, California
Scott L. Letendre
Affiliation:
Department of Medicine, University of California, San Diego, San Diego, California
Ann C. Collier
Affiliation:
Department of Medicine, University of Washington, Seattle, Washington
David B. Clifford
Affiliation:
Department of Neurology, Washington University, St. Louis, Missouri
Benjamin B. Gelman
Affiliation:
Department of Pathology, University of Texas Medical Branch, Galveston, Texas
Christina M. Marra
Affiliation:
Department of Neurology, University of Washington, Seattle, Washington
J. Allen McCutchan
Affiliation:
Department of Medicine, University of California, San Diego, San Diego, California
Susan Morgello
Affiliation:
Department of Neurology, Icahn School of Medicine of Mount Sinai, New York, New York
Ned Sacktor
Affiliation:
Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland
Dilip V. Jeste
Affiliation:
Department of Psychiatry, University of California, San Diego, San Diego, California Stein Institute for Research on Aging, University of California, San Diego, San Diego, California
Igor Grant
Affiliation:
Department of Psychiatry, University of California, San Diego, San Diego, California
Robert K. Heaton
Affiliation:
Department of Psychiatry, University of California, San Diego, San Diego, California
David J. Moore*
Affiliation:
Department of Psychiatry, University of California, San Diego, San Diego, California
the CHARTER and HNRP Groups
Affiliation:
San Diego State University/University of California, San Diego Joint Doctoral Program in Clinical Psychology, San Diego, California Department of Psychiatry, University of California, San Diego, San Diego, California Department of Medicine, University of California, San Diego, San Diego, California Department of Medicine, University of Washington, Seattle, Washington Department of Neurology, Washington University, St. Louis, Missouri Department of Pathology, University of Texas Medical Branch, Galveston, Texas Department of Neurology, University of Washington, Seattle, Washington Department of Neurology, Icahn School of Medicine of Mount Sinai, New York, New York Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland Stein Institute for Research on Aging, University of California, San Diego, San Diego, California
*
Correspondence and reprint requests to: David J. Moore, University of California, San Diego, HIV Neurobehavioral Research Program, 220 Dickinson Street, Suite B, MC8231, San Diego, CA 92103-8231. E-mail: [email protected]
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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. (JINS, 2019, 25, 507–519)

Keywords

NeuropsychologyCognitive reserveCognitive declineDiabetesCannabisAcquired Immunodeficiency Syndrome
Type
Regular Research
Information
Journal of the International Neuropsychological Society , Volume 25 , Issue 5 , May 2019 , pp. 507 - 519
Copyright
Copyright © The International Neuropsychological Society 2019 

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