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Thirteenth Annual Grant Winners 2012-2013

Title

Neurocognitive Sequelae of HIV Infection in the Older Hispanic Adult

Dean

Karen S. Grosby, Ed.D. (CPS)
Anthony J. Silvagni, D.O., Pharm.D. (HPD-OST)

Faculty and Students

Amarilis Acevedo, Ph.D. (CPS)
Raymond Ownby, M.D., Ph.D. (HPD-OST)
Annelly Bure, M.A. (CPS)

Abstract

Neurocognitive Sequelae of HIV Infection in the Older Hispanic AdultBy 2015, more than 50% of HIV+ persons in the United States (US) will be 50 years of age and older. Hispanic* elders in the US are particularly affected, as their rate of HIV/AIDS is 5 times higher than that of their non-Hispanic Caucasian counterparts. HIV affects brain structural and functional integrity, oftentimes resulting in cognitive impairment. Although the introduction of combined antiretroviral therapy has effectively improved immune function and has reduced the prevalence of HIV-associated dementia, the prevalence of other debilitating HIV-associated neurocognitive disorders remains high. Older adults are already at a higher risk of cognitive impairment than younger adults, and infection with HIV places additional neurocognitive burden on this population. Compared to their non-Hispanic Caucasian peers, older Hispanics in the US have higher rates of hypertension, stroke, diabetes, and other factors (e.g., low educational attainment) that increase the risk of neurocognitive impairment. Unfortunately, there is little research on the neurocognitive problems in HIV+ older Hispanics, and little is known about the interaction of medical and non-medical risk factors in their severity and clinical presentation. The proposed study will examine the performance of 20 HIV+ and 20 HIV- Spanish-speaking Hispanics age 50 and older on a battery of neurocognitive tests. The impact of medical (e.g., CD4 levels, viral load), socio-demographic (e.g., acculturation, English proficiency), and mood variables (e.g., depression, anxiety) on neurocognitive status will also be assessed. The primary aim of the study is to obtain pilot data on the intersection of HIV infection, neurocognitive status, and older age among HIV+ Hispanics. This information will be pivotal when applying for external funding for a more comprehensive investigation on this and related HIV+ populations. It will also be a first step in addressing health disparity issues in the assessment and treatment of HIV infection in this understudied population.