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The Role of Neuroplasticity and Cognitive Reserve in Aging With HIV: Recommendations for Cognitive Protection and Rehabilitation

Vance, David E.; Fazeli, Pariya L.; Grant, Joan S.; Slater, Larry Z.; Raper, James L.

Journal of Neuroscience Nursing: October 2013 - Volume 45 - Issue 5 - p 306–316
doi: 10.1097/JNN.0b013e31829d8b29

ABSTRACT By and large, the immune systems of people infected with HIV are being protected and maintained by advances in highly active antiretroviral therapy; as such, this is extending the lives of people into old age. Unfortunately, for many living with this disease, HIV is associated with neuroinflammation, co-morbidities, and accelerated aging which can compromise brain function, resulting in cognitive deficits. The purpose of this article is to highlight how to interpret these deficits within the framework of neuroplasticity and cognitive reserve for this clinical population. We suggest several recommendations for cognitive rehabilitation and mitigation such as addressing lifestyle factors, psychostimulants, cognitive remediation therapy, and treatment of depression and anxiety. Implications for nursing research and practice are posited.

Questions or comments about this article may be directed to David E. Vance, PhD MGS, at He is an Associate Professor at the Department of Family/Child Health and Caregiving, University of Alabama at Birmingham School of Nursing, Birmingham, AL.

Pariya L. Fazeli, BA MA, is a Postdoctoral Fellow at the HIV Neurobehavioral Research Program, University of California, San Diego.

Joan S. Grant, DSN RN, is a Professor at the University of Alabama at Birmingham School of Nursing, Birmingham, AL.

Larry Z. Slater, PhD RN-BC CCRN, is a Clinical Assistant Professor at New York University College of Nursing, New York, NY.

James L. Raper, DSN CRNP JD, is Director at 1917 Clinic and Associate Professor at the Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham School of Medicine, Birmingham, AL.

The authors declare no conflicts of interest.

© 2013 American Association of Neuroscience Nurses