| Publication Abstract Display | | Type: Poster | | Title: Moderate physical activity is associated with better executive functioning in older adults with HIV. | | Authors: Fazeli PL, Dufour C, Marquine MJ, Moore RC, Letendre S, Woods SP, Jeste DV, Grant I, Moore DJ, and the HNRP Group | | Date: 10-30-2013 | | Abstract:Background: Older HIV+ persons may be particularly vulnerable to neurocognitive impairment (NCI) due to the combined effects of HIV and aging on brain structure and function. Identifying potentially modifiable risk factors for NCI among older HIV+ adults is therefore an important research focus. Studies in both the aging and the HIV literature have suggested that physical activity (PA) may represent one feasible approach to ameliorating NCI due to possible direct (e.g., neurogenesis) or indirect (e.g., reduction of comorbidities) effects on the brain. The current study extends these prior findings by examining the associations between NCI and PA frequency, duration, and intensity in an older HIV+ cohort using well-validated assessments of neurocognitive functioning and PA.
Materials and Methods: Preliminary cross-sectional data from 80 older (i.e., ≥ 50 years) HIV+ adults (mean age (SD) = 58.4(6.8); 85% men; 81% white) were assessed. Using the International Physical Activity Questionnaire (IPAQ), participants reported on the frequency and duration of vigorous and moderate PA as well as walking (each independently) over the past seven days. Scoring was conducted according to established procedures for the IPAQ. Participants completed a comprehensive neurocognitive battery that was summarized using global and domain-specific deficit scores derived from published, demographically-adjusted normative data. Participants also completed standardized laboratory, medical, and psychiatric assessments.
Results: Global NCI was identified in 43% (n=34) of the sample. The univariate associations were examined between NCI and IPAQ continuous scores (i.e., minutes/per week X intensity) for each activity level (i.e., vigorous, moderate, walking, and total) and categorical scores (i.e., low, moderate, and high PA). A trend emerged (p=0.06) that showed lower levels of the moderate PA continuous score among those with global NCI. Examination of domain-specific NCI revealed the association between moderate PA and global NCI was driven by executive function (p=0.03). This association between moderate PA and executive function NCI was not better explained by demographic, psychiatric, or disease factors that differed between impairment groups or that were associated with moderate PA.
Conclusions: Consistent with the healthy aging literature, moderate PA is associated with less NCI, particularly less executive dysfunction, among older HIV+ adults. The directionality of this cross-sectional association remains to be determined, but these data suggest that PA may be beneficial for executive functions (e.g., cognitive flexibility). For example, PA may directly impact the brain by promoting neurogenesis and synaptogenesis, or may indirectly impact neurocognition via reduction of risk factors for NCI (e.g., cardiovascular comorbidities). Future randomized interventional studies are warranted to build on these cross-sectional associations and to determine causality as well as to uncover the neural mechanisms whereby PA might affect NCI. |
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