RESUMO
Older people living with HIV (PLWH) are at risk for poorer health-related quality of life (HRQoL). Psychological resilience may protect HRQoL in this population. The sample included 174 predominately African American PLWH (age 40-73). Results indicated associations between resilience, socioeconomic status, cognitive performance, instrumental activities of daily living, personality, and depressive symptoms. HIV factors (e.g. viral load, duration of HIV) were not associated with resilience. Adjusting for confounders, resilience was associated with mental HRQoL. Understanding factors associated with resilience among older PLWH and the translation of resilience to HRQoL may inform interventions to improve well-being among individuals aging with HIV.
Assuntos
Infecções por HIV , Resiliência Psicológica , Atividades Cotidianas/psicologia , Adulto , Idoso , Envelhecimento/psicologia , Infecções por HIV/psicologia , Humanos , Pessoa de Meia-Idade , Qualidade de Vida/psicologiaRESUMO
Background: HIV is a chronic illness that impacts the lives of more than 1 million people in the United States. As persons living with HIV (PWH) are living longer, it is important to understand the influence that religiosity/spirituality has among middle-aged and older PWH.Objective: Compare the degree of religiosity/spirituality among middle-aged and older PWH and HIV-negative individuals, and to identify demographic, clinical, and psychosocial factors associated with religiosity/spirituality among PWH.Method: Baseline data on 122 PWH and 92 HIV-negative individuals (ages 36-65 years; 61.1% Non-Hispanic White) from a longitudinal study were analyzed for the current study. Recruitment occurred through HIV treatment clinics and community organizations in San Diego. Participants completed questionnaires on religiosity, spirituality, and psychosocial functioning. Independent samples t-tests, Pearson correlations, and multiple linear regression analyses were conducted to test the study objective.Results: No significant differences in religiosity/spirituality were found between PWH and HIV-negative individuals. Demographic and psychosocial variables were unrelated to religiously/spirituality among HIV-negative individuals. Among PWH, multiple linear regression models indicated higher daily spirituality was significantly associated with racial/ethnic minority membership (Hispanic/Latino, African American/Black, or Other), fewer years of estimated duration of HIV, greater social support, and higher grit. Greater engagement in private religious practices was significantly associated with racial/ethnic minority membership and higher social support.Conclusions: For PWH, being a racial/ethnic minority and having higher social support was associated with greater engagement in religious/spiritual practices. Future longitudinal studies should examine whether religion/spirituality impacts well-being across the lifespan among racial/ethnic minority groups of PWH.
Assuntos
Infecções por HIV , Espiritualidade , Adulto , Idoso , Etnicidade , Processos Grupais , Infecções por HIV/psicologia , Humanos , Estudos Longitudinais , Pessoa de Meia-Idade , Grupos Minoritários , Religião , Estados UnidosRESUMO
Objective: Poor sleep quality is related to worse neurocognition in older adults and in people with HIV (PWH); however, many previous studies have relied only on self-report sleep questionnaires, which are inconsistently correlated with objective sleep measures. We examined relationships between objective and subjective sleep quality and neurocognition in persons with and without HIV, aged 50 and older. Method: Eighty-five adults (PWH n = 52, HIV-negative n = 32) completed comprehensive neuropsychological testing to assess global and domain-specific neurocognition. Objective sleep quality was assessed with wrist actigraphy (total sleep time, efficiency, sleep fragmentation) for five to 14 nights. Subjective sleep quality was assessed with the Pittsburgh Sleep Quality Index. Results: Objective and subjective sleep measures were unrelated (p's > 0.30). Compared to HIV-negative participants, PWH had greater sleep efficiency (80% vs. 75%, p = 0.05) and were more likely to be using prescription and/or over the counter sleep medication (p = 0.04). In the whole sample, better sleep efficiency (p < 0.01) and greater total sleep time (p = 0.05) were associated with better learning. Less sleep fragmentation was associated with better learning (p < 0.01) and recall (p = 0.04). While PWH had slightly stronger relationships between total sleep time and sleep fragmentation, it is not clear if these differences are clinically meaningful. Better subjective sleep quality was associated with better executive function (p < 0.01) and working memory (p = 0.05); this relationship was primarily driven by the HIV-negative group. Conclusions: Objective sleep quality was associated with learning and recall whereas subjective sleep quality was associated with executive function and working memory. Therefore, assessing objective and subjective sleep quality could be clinically useful, as they are both related to important domains of cognition frequently impacted in HIV-associated neurocognitive disorders as well as neurodegenerative disorders associated with aging. Future studies should evaluate if behavioral sleep interventions can improve neurocognition.
Assuntos
Infecções por HIV , Transtornos do Sono-Vigília , Idoso , Envelhecimento , Infecções por HIV/complicações , Humanos , Pessoa de Meia-Idade , Testes Neuropsicológicos , Sono , Privação do Sono , Transtornos do Sono-Vigília/complicaçõesRESUMO
OBJECTIVE: We developed a mobile cognitive test of verbal learning and memory, the mobile verbal learning test (mVLT), to allow for brief, repeated and portable delivery of a 12-item list learning test through a smartphone. This study examined the psychometric properties of the mVLT among older persons with and without human immunodeficiency virus (HIV). METHODS: Sixty-eight persons with HIV and 36 HIV-negative individuals (aged 50-74) completed three trials of the mVLT on a smartphone once daily for 14 days. A different word list was administered each day. RESULTS: Participants completed 80% of the 14 mVLT administrations, equating to 1166 valid and complete mVLTs. Neither adherence nor mean mVLT total score (number correct in 3 recall trials) differed by HIV status. No practice effects from repeated mVLT administration were observed, and there were moderately strong correlations of mVLT performance with performance on the in-lab version of the task and with traditional cognitive assessments of cognitive processes contributing to memory. We found evidence of within-person learning across mVLT trials, with persons with HIV demonstrating less learning from trials 1 to 3 compared to HIV-negative participants. CONCLUSIONS: The mVLT is a valid method to assess learning in the real world in older adults with and without HIV.
Assuntos
Disfunção Cognitiva , Aprendizagem Verbal , Idoso , Idoso de 80 Anos ou mais , Cognição , Disfunção Cognitiva/diagnóstico , Disfunção Cognitiva/etiologia , Humanos , Testes Neuropsicológicos , SmartphoneRESUMO
OBJECTIVE: To examine feasibility, convergent validity and biases associated with a mobile color-word interference test (mCWIT) among older persons living with HIV (PLHIV). METHOD: Over a 14-day period, 58 PLHIV and 32 HIV-uninfected individuals (aged 50-74) completed the mCWIT on smartphones once per day in real-world settings. Participants also completed a comprehensive laboratory-based neuropsychological evaluation. RESULTS: A high rate of compliance was observed (86%) in the repeated administration of the mCWIT. A practice effect was observed in the overall sample concerning mCWIT subscores, and these learning effects were greater for PLHIV. Stabilization of performance was observed after 6 (HIV+) and 7 days (HIV-) for completion time and after 2 (HIV-) and 3 days (HIV+) for mCWIT errors. A minor fatigue effect was observed in the overall sample which was unassociated with group status. Moderate to strong correlations were found between mCWIT completion time and mCWIT errors with global neurocognition and with all of the individual neurocognitive domains. The strongest associations were with mCWIT completion time and laboratory-based global neurocognition, executive function, and working memory scores. CONCLUSIONS: Cognitive testing administered within the context of a person's daily life provides qualitatively different data than neuropsychological testing completed in clinical settings, and it may constitute a more ecologically valid indicator of cognitive performance than traditional methods. Mobile cognitive testing has potential to help characterize real-time cognitive performance and serve as a complementary assessment tool to traditional methods.