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01-06-2009 | Review

The Neuropsychology of HIV/AIDS in Older Adults

Authors: David J. Hardy, David E. Vance

Published in: Neuropsychology Review | Issue 2/2009

Abstract

Highly active antiretroviral therapy is allowing increasing numbers of adults to age with HIV. The neuropsychological effects of aging with HIV are reviewed through three types of studies. First, the separate effects of HIV and aging on cognition are examined in studies that compare younger adults with HIV with neurologically normal older adults. Second, studies examine the impact of aging within samples of adults with HIV only. Third, providing the most critical evidence, are studies that assess cognition in younger and older adults with HIV relative to younger and older adults without HIV. In general research findings are inconclusive. Large individual differences among older adults with HIV as well as co-factors (APOE4 and detectable viral load) may account for inconsistent findings in the literature. A subgroup of older adults with HIV may be at greater risk for cognitive impairment, especially in attention functioning.

Arendt, G., Hefter, H., Nelles, H. W., Hilperath, F., & Strohmeyer, G. (1993). Age-dependent decline in cognitive information processing of HIV-positive individuals detected by event-related potential recordings. Journal of the Neurological Sciences, 115, 223–229. doi:10.1016/0022-510X(93)90229-R.CrossRefPubMed

Barclay, T. R., Hinkin, C. H., Castellon, S. A., Mason, K. I., Reinhard, M. J., Marion, S. D., et al. (2007). Age-associated predictors of medication adherence in HIV-positive adults: health beliefs, self-efficacy, and neurocognitive status. Health Psychology, 26, 40–49. doi:10.1037/0278-6133.26.1.40.CrossRefPubMed

Bashore, T. R. (1993). Differential effects of aging on the neurocognitive functions subserving speeded mental processing. In J. Cerella, J. Rybash, W. Hoyer, & M. L. Commons (Eds.), Adult information processing: Limits on loss (pp. 37–76). San Diego: Academic Press.

Becker, J. T., Sanchez, J., Dew, M. A., Lopez, O. L., Dorst, S. K., & Banks, G. (1997). Neuropsychological abnormalities among HIV-infected individuals in a community-based sample. Neuropsychology, 11, 592–601. doi:10.1037/0894-4105.11.4.592.CrossRefPubMed

Becker, J. T., Lopez, O. L., Dew, M. A., & Aizenstein, H. J. (2004). Prevalence of cognitive disorders differs as a function of age in HIV virus infection. AIDS (London, England), 18, 11–18. doi:10.1097/00002030-200401001-00003.

Beer, J. S., Shimamura, A. P., & Knight, R. T. (2004). Frontal lobe contributions to executive control of cognitive and social behavior. In M. S. Gazzaniga (Ed.), The cognitive neurosciences, 3rd edn (pp. 1091–1104). Cambridge: MIT Press.

Brew, B. J. (2004). Evidence for a change in AIDS dementia complex in the era of highly active antiretroviral therapy and the possibility of new forms of AIDS dementia complex. AIDS (London, England), 18, 75–78. doi:10.1097/00002030-200401001-00011.

Centers for Disease Control and Prevention. (2007). Estimated numbers of persons living with HIV/AIDS, by year and selected characteristics, 2001–2004. Cited at www.cdc.gov/hiv/topics/surveillance/resources/reports/2004report/table8.htm.

Cherner, M., Ellis, R. J., Lazzaretto, D., Young, C., Mindt, M. R., Atkinson, J. H., et al. (2004). Effects of HIV-1 infection and aging on neurobehavioral functioning: preliminary findings. AIDS (London, England), 18, 27–34. doi:10.1097/00002030-200401001-00005.

Comstock, J. R., & Arnegard, R. J. (1992). The multi-attribute task battery for human operator workload and strategic behavior research (Tech. Memorandum No. 104174). Hampton: NASA Langley Research Center.

Concha, M., Graham, N. M. H., Munoz, A., Vlahov, D., Royal, W., Updike, M., et al. (1992). Effect of chronic substance abuse on the neuropsychological performance of intravenous drug users with a high prevalence of HIV-1 seropositivity. American Journal of Epidemiology, 136, 1338–1348.PubMed

Conigliaro, J., Justice, A. C., Gordon, A. J., & Bryant, K. (2006). Role of alcohol in determining human immunodeficiency virus (HIV)-relevant outcomes: a conceptual model to guide the implementation of evidence-based interventions into practice. Medical Care, 44, 1–6. doi:10.1097/01.mlr.0000223659.36369.cf.CrossRef

Connor, M. D., Lammie, G. A., Bell, J. E., Warlow, C. P., Simmonds, P., & Brettle, R. D. (2000). Cerebral infarction in adult AIDS patients: observation from the Edinburgh HIV autopsy cohort. Stroke, 31, 2117–2126.PubMed

Cook, R. L., Sereika, S. M., Hunt, S. C., Woodward, W. C., Erlen, J. A., & Conigliaro, J. (2001). Problem drinking and medication adherence among persons with HIV infection. Journal of General Internal Medicine, 16, 83–88. doi:10.1111/j.1525-1497.2001.00122.x.CrossRefPubMed

Craik, F. I. M., & Salthouse, T. A. (Eds.), (1992). The handbook of aging and cognition. Hillsdale, NJ: Lawrence Erlbaum and Associates.

Craik, F. I. M., & Salthouse, T. A. (Eds.), (2000). The handbook of aging and cognition (2nd ed.). Hillsdale, NJ: Lawrence Erlbaum and Associates.

Czigler, I., Csibra, G., & Ambro, A. (1997). Age and information processing: event-related potential studies. European Psychologist, 2, 247–257. doi:10.1027/1016-9040.2.3.247.CrossRef

El Yagoubi, R., Lemaire, P., & Besson, M. (2005). Effects of aging on arithmetic problem-solving: an even-related brain potential study. Journal of Cognitive Neuroscience, 17, 37–50. doi:10.1162/0898929052880084.CrossRefPubMed

Ernst, T., & Chang, L. (2004). Effect of aging on brain metabolism in antiretroviral-naïve HIV patients. AIDS (London, England), 18, 61–67. doi:10.1097/00002030-200401001-00009.

Fama, R., Pfefferbaum, A., & Sullivan, E. V. (2004). Perceptual learning in detoxified alcoholic men: contributions from explicit memory, executive function, and age. Alcoholism, Clinical and Experimental Research, 28, 1657–1665. doi:10.1097/01.ALC.0000145690.48510.DA.CrossRefPubMed

Fama, R., Eisen, J. C., Rosenbloom, M. J., Sassoon, S. A., Kemper, C. A., Deresinski, S., et al. (2007). Upper and lower limb motor impairments in alcoholism, HIV infection, and their comorbidity. Alcoholism, Clinical and Experimental Research, 31, 1038–1044. doi:10.1111/j.1530-0277.2007.00385.x.CrossRefPubMed

Galvan, F. H., Bing, E. G., Fleishman, J. A., London, A. S., Caetano, R., Burnam, M. A., et al. (2002). The prevalence of alcohol consumption and heavy drinking among people with HIV in the United States: results from the HIV Cost and Services Utilization Study. Journal of Studies on Alcohol, 63, 179–186.PubMed

Gordon, S. M., Kennedy, B. P., & McPeake, J. D. (1988). Neuropsychologically impaired alcoholics: assessment, treatment considerations, and rehabilitation. Journal of Substance Abuse Treatment, 5, 99–104. doi:10.1016/0740-5472(88)90019-0.CrossRefPubMed

Gottlieb, M. S., Schanker, H. M., Fan, P. T., Saxon, A., Weisman, J. D., & Pozalski, I. (1981). Pneumocystis pneumonia—Los Angeles. Morbidity and Mortality Weekly Report, 30(21), 1–3.

Grant, I., & Martin, A. (1994). Neuropsychology of HIV infection. New York: Oxford University Press.

Grassi, M. P., Clerci, F., Perin, C., Zocchetti, C., Borella, M., Cargnel, A., & Mangoni, A. (1995). HIV infection and drug use: influence on cognitive function. AIDS (London, England), 9, 165–170. doi:10.1097/00002030-199509020-00008.

Grotemeyer, K. H., Husstedt, I. W., Brundermann, H., Busch, H., Schlake, H. P., & Zidek, W. (1991). Event-related potentials in HIV-infected outpatients. AIDS Research and Human Retroviruses, 7, 629–635.CrossRefPubMed

Hardy, D. J., Hinkin, C. H., Satz, P., Stenquist, P. K., van Gorp, W. G., & Moore, L. H. (1999). Age differences and neurocognitive performance in HIV-infected adults. New Zealand Journal of Psychology, 28, 94–101.

Hardy, D. J., Satz, P., Stefaniak, M., van Gorp, W. G., Hinkin, C. H., & Stenquist, P. K. (1999). Cognition in older adults with AIDS. Poster presented at the 4th Annual UCLA Research Conference on Aging.

Hardy, D. J., Borghi, S., Lodato, J., Zolnikof, B., Miller, E. N., Green, M., et al. (2004). Older HIV-infected adults and multi-task performance. Poster presented at the 24th Annual Conference of the National Academy of Neuropsychology, Seattle, Washington.

Hartley, A. A. (1992). Attention. In F. I. M. Craik, & T. A. Salthouse (Eds.), The handbook of aging and cognition (pp. 3–49). Hillsdale: Lawrence Erlbaum Associates.

Heaton, R. K., Grant, I., Butters, N., White, D. A., Kirson, D., Atkinson, J. H., et al. (1995). The HNRC 500—Neuropsychology of HIV infection at different disease stages. Journal of the International Neuropsychological Society, 1, 231–251.CrossRefPubMed

Heaton, R. K., Grant, I., & Matthews, C. G. (1986). Differences in neuropsychological test performance associated with age, education and sex. In I. Grant, & K. M. Adams (Eds.), Neuropsychological Assessment of Neuropsychiatric Disorders (pp. 100–120). New York: Oxford University Press.

Hicks, L. H., & Birren, J. E. (1970). Aging, brain damage, and psychomotor slowing. Psychological Bulletin, 74, 377–396. doi:10.1037/h0033064.CrossRefPubMed

Hinkin, C. H., Cummings, J. L., van Gorp, W. G., Satz, P., Mitrushina, M., & Freeman, D. (1990). Frontal/subcortical features of normal aging: an empirical analysis. Canadian Journal on Aging, 9, 104–119.

Hinkin, C. H., Castellon, S. A., van Gorp, W. G., & Satz, P. (1998). Neuropsychological features of HIV disease. In W. G. van Gorp, & S. L. Buckingham (Eds.), Practitioner’s guide to the neuropsychiatry of HIV/AIDS (pp. 1–41). New York: The Guilford Press.

Hinkin, C. H., Castellon, S. A., Atkinson, J. H., & Goodkin, K. (2001). Neuropsychiatric aspects of HIV infection among older adults. Journal of Clinical Epidemiology, 54, 44–52. doi:10.1016/S0895-4356(01)00446-2.CrossRef

Hinkin, C. H., Hardy, D. J., Mason, K. I., Castellon, S. A., Durvasula, R. S., Lam, M. N., & Stefaniak, M. (2003). Medication adherence in HIV-infected adults: effect of patient age, cognitive status, and substance abuse. AIDS (London, England), 17, 1–7. doi:10.1097/00002030-200301030-00003.

Justice, A. C., McGinnis, K. A., Atkinson, J. H., Heaton, R. K., Young, C., Sadek, J., et al. (2004). Psychiatric and neurocognitive disorders among HIV-positive and negative veterans in care: veterans Aging Cohort Five-Site Study. AIDS (London, England), 18, 49–59. doi:10.1097/00002030-200401001-00008.

Linnville, S. E., Elliott, F. S., & Larson, G. E. (1996). Event-related potentials as indices of subclinical neurological differences in HIV patients during rapid decision making. The Journal of Neuropsychiatry and Clinical Neurosciences, 8, 293–304.PubMed

Mahncke, H. W., Bronstone, A., & Merzenich, M. M. (2006). Brain plasticity and functional losses in the aged: scientific bases for novel intervention. Progress in Brain Research, 157, 81–109. doi:10.1016/S0079-6123(06)57006-2.CrossRefPubMed

Marcotte, T. D., Heaton, R. K., Wolfson, T., Taylor, M. J., Alhassoon, O., Arfaa, K., et al. (1999). The impact of HIV-related neuropsychological dysfunction on driving behavior. Journal of the International Neuropsychological Society, 5, 579–592. doi:10.1017/S1355617799577011.CrossRefPubMed

Marcotte, T. D., Wolfson, T., Rosenthal, T. J., Heaton, R. K., Gonzalez, R., Ellis, R. J., et al. (2004). A multimodal assessment of driving performance in HIV infection. Neurology, 63, 1417–1422.PubMed

Marcotte, T. D., Lazzaretto, D., Scott, J. C., Roberts, E., Woods, S. P., Letendre, S., et al. (2006). Visual attention deficits are associated with driving accidents in cognitively-impaired HIV-infected individuals. Journal of Clinical and Experimental Neuropsychology, 28, 13–28. doi:10.1080/13803390490918048.CrossRefPubMed

McArthur, J. C., & Grant, I. (1998). HIV neurocognitive disorders. In H. E. Gendelman, S. A. Lipton, L. Epstein, & S. Swindells (Eds.), The neurology of AIDS (pp. 499–523). New York: Chapman & Hall.

Nelson, E. A., & Dannefer, D. (1992). Aged heterogeneity: fact or fiction? The fate of diversity in gerontological research. The Gerontologist, 32, 17–23. doi:10.1159/000116781.PubMed

Parasuraman, R., & Haxby, J. V. (1993). Attention and brain function in Alzheimer’s Disease. Neuropsychology, 7, 242–272. doi:10.1037/0894-4105.7.3.242.CrossRef

Parasuraman, R., Greenwood, P. M., & Sunderland, T. (2002). The apolipoprotein E gene, attention, and brain function. Neuropsychology, 16, 254–274. doi:10.1037/0894-4105.16.2.254.CrossRefPubMed

Pfefferbaum, A., Ford, J. M., Wenegrat, B. G., Roth, W. T., & Kopell, B. S. (1984). Clinical application of the p3 component of event-related potentials. I. Normal aging. Electroencephalography and Clinical Neurophysiology, 59, 85–103. doi:10.1016/0168-5597(84)90026-1.CrossRefPubMed

Pfefferbaum, A., Adalsteinsson, E., & Sullivan, E. V. (2005). Cortical NAA deficits in HIV infection without dementia: influence of alcoholism comorbidity. Neuropsychopharmacology, 30, 1392–1399. doi:10.1038/sj.npp.1300623.CrossRefPubMed

Picton, T. W., Stuss, D. T., Champagne, S. C., & Nelson, R. F. (1984). The effects of age on human event-related potentials. Psychophysiology, 21, 312–325. doi:10.1111/j.1469-8986.1984.tb02941.x.CrossRefPubMed

Polich, J., Ilan, A., Poceta, J. S., Mitler, M. M., & Darko, D. F. (2000). Neuroelectric assessment of HIV: EEG, ERP, and viral load. International Journal of Psychophysiology, 38, 97–108. doi:10.1016/S0167-8760(00)00133-1.CrossRefPubMed

Raz, N., & Rodrigue, K. M. (2006). Differential aging of the brain: patterns, cognitive correlates and modifiers. Neuroscience and Biobehavioral Reviews, 30, 730–748. doi:10.1016/j.neubiorev.2006.07.001.CrossRefPubMed

Rugg, M. D., & Coles, M. G. H. (Eds.), (1995). Electrophysiology of mind. Oxford: Oxford University Press.

Salthouse, T. A. (1994). How many causes are there of aging-related decrements in cognitive functioning? Developmental Review, 14, 413–437. doi:10.1006/drev.1994.1016.CrossRef

Sassoon, S. A., Fama, R., Rosenbloom, M. J., O’Reilly, A., Pfefferbaum, A., & Sullivan, E. V. (2007). Component cognitive and motor processes of the Digit Symbol Test: differential deficits in alcoholism, HIV infection, and their comorbidity. Alcoholism, Clinical and Experimental Research, 31, 1315–1324. doi:10.1111/j.1530-0277.2007.00426.x.CrossRefPubMed

Schaie, K. W. (1996). Intellectual development in adulthood. In J. E. Birren, & K. W. Schaie (Eds.), Handbook of the psychology of aging, 4th edn (pp. 266–286). San Diego: Academic Press.

Stern, Y. (1994). Neuropsychological assessment of seropositive intravenous drug users. In I. Grant, & A. Martin (Eds.), Neuropsychology of HIV infection (pp. 220–233). New York: Oxford University Press.

Stoff, D. M. (2004). Mental health research in HIV/AIDS and aging: problems and prospects. AIDS (London, England), 18, 3–10. doi:10.1097/00002030-200401001-00002.

Stoff, D. M., Khalsa, J. H., Monjan, A., & Portegies, P. (2004). Introduction: HIV/AIDS and aging. AIDS (London, England), 18, 1–2. doi:10.1097/00002030-200401001-00001.

Takakuwa, K. M., Callaway, E., Naylor, H., Herzig, K. E., & Yano, L. M. (1993). The effects of the Human Immunodeficiency Virus on visual information processing. Biological Psychiatry, 34, 194–197. doi:10.1016/0006-3223(93)90392-Q.CrossRefPubMed

Tartar, J. L., Sheehan, C. M., Nash, A. J., Starratt, C., Puga, A., & Widmayer, S. (2004). ERPs differ from neurometric tests in assessing HIV-associated cognitive deficit. Neuroreport, 15, 1675–1678. doi:10.1097/01.wnr.0000134992.74181.4b.CrossRefPubMed

Valcour, V., Shikuma, C., Shiramizu, M., Watters, M., Poff, P., Selnes, O. A., et al. (2004). Age, apolipoprotein E4, and the risk of HIV dementia: the Hawaii Aging with HIV Cohort. Journal of Neuroimmunology, 157, 197–202. doi:10.1016/j.jneuroim.2004.08.029.CrossRefPubMed

Valcour, V. G., Shikuma, C. M., Watters, M. R., & Sactor, N. C. (2004). Cognitive impairment in older HIV-1-seropositive individuals: prevalence and potential mechanisms. AIDS (London, England), 18, 79–86. doi:10.1097/00002030-200401001-00012.

Valcour, V., Shikuma, C., Shiramizu, B., Watters, M., Poff, P., Selnes, O., et al. (2006). Higher frequency of dementia in older HIV-1 individuals. The Hawaii Aging with HIV-1 Cohort. Neurology, 63, 822–827.

van Gorp, W. G., & Mahler, M. (1990). Subcortical features of normal aging. In J. L. Cummings (Ed.), Subcortical dementia (pp. 231–250). New York: Oxford University Press.

van Gorp, W. G., Mitrushina, M., Cummings, J. L., Satz, P., & Modesitt, J. (1989). Normal aging and the subcortical encephalopathy of AIDS. A neuropsychological comparison. Neuropsychiatry, Neuropsychology, and Behavioral Neurology, 2, 5–20.

van Gorp, W. G., Miller, E. N., Marcotte, T. D., Dixon, W., Paz, D., Selnes, O., et al. (1994). The relationship between age and cognitive impairment in HIV-1 infection: findings from the Multicenter AIDS Cohort Study and a clinical cohort. Neurology, 44, 929–935.PubMed

Vance, D. E. (2004). Cortical and subcortical dynamics of aging with HIV infection. Perceptual and Motor Skills, 98, 647–655. doi:10.2466/PMS.98.2.647-655.CrossRefPubMed

Vance, D. E., & Robinson, F. P. (2004). Reconciling successful aging with HIV: a biopsychosocial overview. Journal of HIV/AIDS & Social Services, 3, 59–78. doi:10.1300/J187v03n01_06.CrossRef

Vance, D. E., & Burrage Jr., J. W. (2006). Promoting successful cognitive aging in adults with HIV: strategies for intervention. Journal of Gerontological Nursing, 32(11), 34–41.PubMed

Vance, D. E., Woodley, R. A., & Burrage Jr., J. A. (2007). Predictors of cognitive ability in adults aging with HIV: a pilot study. Clinical Gerontologist, 30(3), 83–101. doi:10.1300/J018v30n03_07.CrossRef

West, R., & Schwarb, H. (2006). The influence of aging and frontal function on the neural correlates of regulative and evaluative aspects of cognitive control. Neuropsychology, 20, 468–481. doi:10.1037/0894-4105.20.4.468.CrossRefPubMed

Wilkie, F. L., Goodkin, K., Khamis, I., van Zuilen, M. H., Lee, D., Lecusy, R., et al. (2003). Cognitive functioning in younger and older HIV-1-infected adults. Journal of Acquired Immune Deficiency Syndromes, 33, 93–105.

Woodruff-Pak, D. S. (1997). The neuropsychology of aging. Malden: Blackwell Publishers Inc.

Title: The Neuropsychology of HIV/AIDS in Older Adults
Authors: David J. Hardy
David E. Vance
Publication date: 01-06-2009
Publisher: Springer US
Published in: Neuropsychology Review / Issue 2/2009
Print ISSN: 1040-7308
Electronic ISSN: 1573-6660
DOI: https://doi.org/10.1007/s11065-009-9087-0

Keynote webinar | Spotlight on medication adherence

Springer Medicine

The Neuropsychology of HIV/AIDS in Older Adults

Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

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