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Cognitive Reserve Over the Lifespan

Neurocognitive Implications for Aging With HIV

Vance, David E. PhD, MGS*; Lee, Loretta PhD, RN, CRNP, FNP-BC; Muñoz-Moreno, Jose A. PhD; Morrison, Shannon PhD, RN; Overton, Turner MD; Willig, Amanda PhD; Fazeli, Pariya L. PhD

Journal of the Association of Nurses in AIDS Care: September-October 2019 - Volume 30 - Issue 5 - p e109–e121
doi: 10.1097/JNC.0000000000000071
Research Article
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Approximately 59% of adults living with HIV experience HIV-associated neurocognitive disorder, a collection of symptoms and cognitive deficits in various cognitive domains. As the HIV population ages, the prevalence and severity of such cognitive deficits are expected to grow. Understanding how these cognitive deficits manifest is important for nurses and health care providers. This article provides an overview of cognitive reserve and evidence of how it is compromised by HIV, aging, and individual characteristics. Within this context of cognitive reserve, the role of neuroinflammation, neurotoxicity, substance use, comorbidities, depression and anxiety, social isolation, and sedentary lifestyle is reviewed. From this, strategies used to address cognitive deficits are provided, including topics such as psychostimulants, cognitive training, multimodal lifestyle interventions, and compensation strategies. Scenarios of successful and unsuccessful cognitive aging are presented to provide a lifespan perspective of cognitive reserve. Implications for clinical practice and research are provided, as it relates to aging.

David E. Vance, PhD, MGS, is Professor and Interim Associate Dean for Research and Scholarship, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA. Loretta Lee, PhD, is Associate Professor, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA. Jose A. Muñoz-Moreno, PhD, is a Collaborating Professor, Fundació Lluita contra la Sida, Hospital Universitari Germans Trias i Pujol, Barcelona, Catalonia, Spain. Shannon Morrison, PhD, is Associate Professor, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA. Turner Overton, MD, is Associate Professor, Division of Infectious Diseases, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA. Amanda Willig, PhD, is Assistant Professor, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA. Pariya L. Fazeli, PhD, is Assistant Professor, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA.

Corresponding author: David E. Vance, e-mail: devance@uab.edu

Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article.

© 2019 Association of Nurses in AIDS Care
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