期刊
JAIDS-JOURNAL OF ACQUIRED IMMUNE DEFICIENCY SYNDROMES
卷 61, 期 3, 页码 341-348出版社
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/QAI.0b013e31826bfc53
关键词
HIV; aging; assessment; daily functioning; health status; disability
资金
- NIH [T32 AA013525, T32 DA31098, MH73419, P50 DA26306, MH62512, MH59745, R01 MH92225, P30 MH62512, R01 MH083969 01A2, R01 MH73419, R01 MH058076, U01 MH83506, R01 MH83552, R01 MH095621, U01 NS32228, P01 DA12065, N01 MH22005, R01 MH78748, R01 AG15301]
- New Investigator Research Grant (Alzheimer's Association) [09 134067]
- National Institute of Aging (NIA) [5 R01 AG012674 14]
- Congressionally Directed Medical Research Programs (CFMRP)/Department of Defense (DoD)
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.
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