Synergistic Effects of HIV Infection and Older Age on Daily Functioning
Year: 2012
Type: article
Study design: Observational Study
Abstract: OBJECTIVE: To determine whether HIV infection and aging act synergistically to disrupt everyday functioning. DESIGN: Cross-sectional factorial study of everyday functioning in the context of HIV serostatus and age (≤40 years vs. ≥50 years). METHODS: One hundred three HIV+ and 87 HIV- participants were administered several measures of everyday functioning, including self-report indices of health-related quality of life (HRQoL) and instrumental and basic activities of daily living (IADLs and BADLs), and objective measures of functioning, including employment and Karnofsky Performance Scale ratings. RESULTS: Significant interaction effects of HIV and aging were observed for IADL and BADL declines, and for Karnofsky Performance Scale ratings (Ps < 0.05), independent of potentially confounding factors. Follow-up contrasts revealed significantly worse functioning in the older HIV+ group for most functional outcome measures relative to the other study groups (Ps < 0.05). A significant interaction effect was also observed on the emotional functioning HRQoL subscale, and additive effects of both age and HIV were observed for the physical functioning and general health perceptions HRQoL subscales (Ps < 0.05). Significant predictors of poorer functioning in the older HIV+ group included current major depressive disorder for all outcomes, and comorbid medical conditions, lower estimated premorbid functioning, neurocognitive impairment, and nadir CD4 count for selected outcomes. CONCLUSION: Findings suggest that older age may exacerbate the adverse effects of HIV on daily functioning, which highlights the importance of evaluating and monitoring the functional status of older HIV-infected adults. Early detection of functional difficulties could facilitate delivery of compensatory strategies (eg, cognitive remediation) or assistive services.
Language: English
Subfield: Emergency Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: green
Awards: G1218683495, California NeuroAIDS Tissue Network (CNTN), G1469043609, G1488485918, G1793251574, G1857077138, G2005831020, HIV Neurocognitive Disorders: A Randomized Clinical Trial of CNS-Targeted HAART, Translational Methamphetamine AIDS Research Center (TMARC), Clinical Trial of CNS Penetrating ART to Prevent NeuroAIDS in China, G2332437274, G2349863769, G2421492189, G25173860, Structural and Functional Brain Aging in Bipolar Disorder, CNS HIV Anti-Retroviral Therapy Effects Research (CHARTER), G3248108200, G3611395682, G3973242703, Prospective Memory in HIV-1 Infection, G4405730308, NEUROAIDS: EFFECTS OF METHAMPHETAMINE AND HCV, G4718875706, G4739025049, G4778247569, G534706855, G5531109430, G5598595415, G6353447075, G645235059, G6765565531, Proteomic Strategies for AIDS and Drug Abuse - HIV and METH CNS Synergy, G7240240218, G752243759, NEUROLOGIC AIDS RESEARCH CONSORTIUM, Training in Research on Addictions in Interdisciplinary NeuroAIDS (TRAIN), HIV Neurobehavioral Research Center, Alcohol Research in the Science/Practitioner Model, G900990252
OpenAlex ID: W2044704287