05/11 – 05/12
Type: 5P30AI051519-09 supplement
Principal Investigator: J. Verghese
Agency: National Institute of Allergy and Infectious Diseases
Adults age 50 and over account for more than 20% of persons living with human immunodeficiency virus (HIV) infection in USA. Cognitive dysfunction occurs early in the HIV disease course, and predicts worse outcomes and rapid progression. A key gap in our knowledge is the paucity of information on early clinical markers and interventions for HIV related cognitive dysfunction in older patients. We propose to translate insights from our aging research to study HIV aging. We hypothesize that HIV-induced neuronal damage will manifest in subtle and early cognitive and motor changes. Within-person across-neuropsychological test variability in our aging cohort predicted dementia independent of neuropsychological test performance. We also identified sensitive quantitative gait measures that predict cognitive and motor decline in aging. Building on our extensive aging research and access to a large aging HIV clinic population, we propose the following aims: 1). Establish role of early cognitive and motoric markers of aging related HIV neuronal damage in 25 recently HIV diagnosed patients age 50 and older, 25 previously diagnosed HIV patients who survived to age 50 and older and 25‘young’ HIV controls (<50 years); 2). Establish contributions of cognitive reserve to ameliorating HIV related neuronal damage; 3). Develop collaborations and capacity to support HIV aging research at Einstein. The infusion of new non-HIV investigators will enhance the Einstein CFAR capacity to conduct innovative and high impact studies in HIV aging. Our proposal will offer value added contributions not only locally but also to the national HIV research and clinical care endeavors by building an HIV aging research infrastructure , determining effects of age-related changes on HIV cognitive and physical function, testing new diagnostic tools, and identifying the role of potentially modifiable risk factors for cognitive decline inpatients aging with HIV.
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