Journal of Gerontological Social Work ( IF 3.608 ) Pub Date : 2021-09-12 , DOI: 10.1080/01634372.2021.1978028 David E Vance 1 , Yookyong Lee 2 , David Scott Batey 2 , Wei Li 3 , Crystal Chapman Lambert 1 , Sai Rashmi Nakkina 4 , Joseph N Anderson 5 , Kristen Triebel 5 , Jun Y Byun 1 , Pariya L Fazeli 1
ABSTRACT
Cognitive impairments have been endemic to the HIV epidemic since its beginning and persist to this day. These impairments are attributed to HIV-induced neuroinflammation, the long-term effects of combination antiretroviral therapy, lifestyle factors (e.g., sedentary behavior, substance use), neuro-comorbidities (e.g., depression), age-associated comorbidities (e.g., heart disease, hypertension), and others causes. Normal aging and lifestyle also contribute to the development of cognitive impairment. Regardless of the etiology, such cognitive impairments interfere with HIV care (e.g., medication adherence) and everyday functioning (e.g., driving safely, financial management). With more than half of people with HIV (PWH) 50 years and older, and ~45% of all PWH meeting the criteria for HIV-Associated Neurocognitive Disorder (HAND), those aging PWH are more vulnerable for developing cognitive impairment. This article provides an update to a social work model to identify and monitor PWH for cognitive impairment. Within this update, the state of the science on protecting brain health and cognitive reserve within the context of neuroHIV is also presented. From this, implications for practice and policy to promote successful cognitive functioning in older PWH are provided.
中文翻译:
艾滋病认知老化的新方向:社会工作的实践和政策意义
摘要
认知障碍从艾滋病流行开始就一直是地方病,并且一直持续到今天。这些损伤归因于 HIV 诱导的神经炎症、联合抗逆转录病毒疗法的长期影响、生活方式因素(例如,久坐行为、物质使用)、神经合并症(例如,抑郁症)、与年龄相关的合并症(例如,心脏病) ,高血压)和其他原因。正常的衰老和生活方式也会导致认知障碍的发展。无论病因如何,这种认知障碍都会干扰 HIV 护理(例如,药物依从性)和日常功能(例如,安全驾驶、财务管理)。超过一半的 HIV 感染者 (PWH) 年龄在 50 岁及以上,大约 45% 的 PWH 符合 HIV 相关神经认知障碍 (HAND) 的标准,那些老化的 PWH 更容易出现认知障碍。本文提供了社会工作模型的更新,以识别和监测 PWH 的认知障碍。在本次更新中,还介绍了在神经 HIV 的背景下保护大脑健康和认知储备的科学现状。由此,提供了对促进老年 PWH 成功认知功能的实践和政策的启示。