HIV, Aging and Cognition: A Synergism?

艾滋病毒、衰老和认知：协同作用？

• 批准号: 7150052
• 负责人: KARL GOODKIN
• 金额: $ 67.1万
• 依托单位: UNIVERSITY OF MIAMI SCHOOL OF MEDICINE
• 依托单位国家: 美国
• 财政年份: 2004
• 资助国家: 美国
• 起止时间: 2004-01-16 至 2007-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7150052
• 关键词: Accounting; Acquired Immunodeficiency Syndrome; Activities of Daily Living; Affect; Age; Aging; Attention; CD4 Lymphocyte Count; CD4 Positive T Lymphocytes; CD4/CD8 ratio procedure; CD8-Positive T-Lymphocytes; Categories; Cell Count; Centers for Disease Control and Prevention (U.S.); Clinical; Cognition; Cognitive; Cohort Studies; Data; Diagnosis; Disease; Ear; Educational Status; Episodic memory; Ethnic Origin; Frequencies; HIV; HIV-1; HIV-2; Highly Active Antiretroviral Therapy; Immune; Immunologics; Impairment; Individual; Infection; Inflammatory; Language; Link; Longitudinal Studies; Measurement; Measures; Mediating; Minor; Motor; Neuropsychological Tests; Outcome Measure; Participant; Performance; Plasma; Process; Production; Proteins; Research Design; Severities; Short-Term Memory; Socioeconomic Status; Staging; Symptoms; T-Lymphocyte Subsets; Time; Viral Load result; Visuospatial; age related; base; clinically relevant; cognitive control; cohort; cytokine; cytotoxic; executive function; follow-up; functional status; motor disorder; motor impairment; neuropsychological; peripheral blood; processing speed; protein expression; reconstitution; synergism

DESCRIPTION (provided by applicant): This is a proposal for a renewal of a longitudinal study to extend a current 5-year study relating older age to tile progression of HIV-I infection. Tile original study compared older (greater than or equal to 50) to younger (18-39) H1V+ individuals and to older and younger HIV- individuals. HIV+ individuals were in the early and late symptomatic stages of infection. Associations with older age dependent upon HIV serostatus were observed on neuropsychological performance, the symptoms of minor cognitive-motor disorder, immune measures (CD4/CD8 ratio; CD4 cell count; CD8 cell count), and plasma viral load. The renewal will focus upon recruitment of an additional 95 participants according to a matching strategy on educational level, ethnicity, and socioeconomic status. These participants will be join in the longitudinal follow-up of the original cohort and be examined for changes in neuropsychological performance using an expanded N P battery adding a domain for working memory as well as increased assessment of the motor domain. The diagnosis and symptoms of minor cognitive-motor disorder wilt likewise be studied for age-associated effects. Questions will also be directed to newly proposed outcome measures. The original study aim on differences in overall functional status will now be more focused, examining cognition-specific functional status [a defining criterion of cognitive-motor disorder]. The findings on age-associated immunologic changes (in the CD4/CD8 ratio, CD4 cell count, and CD8 cell count) will be pursued. The naive subsets of CD4 cells will be enumerated, and cytokines produced by the Thl and Th2 subsets of CD4 cells will be quantified. Regarding age-associated increases in CD8 cell count we observed in older HIV+ individuals, the cytotoxic T lymphocyte subset of CD8 cells will be enumerated. As the observed age-associated immune changes were not mediated by plasma viral load, HIV-1 protein expression will be examined together with the associated production of pro-inflammatory cytokines known to be linked to cognitive-motor impairment and disorder. Control variables have been focused upon using a data reduction strategy. The findings may have great clinical relevance for the management of older HIV-infected individuals.

描述（由申请人提供）：这是一项更新纵向研究的提案，以扩展当前的 5 年期研究，该研究涉及老年与 HIV-1 感染进展的关系。最初的研究比较了老年（大于或等于 50 岁）和年轻（18-39 岁）H1V+ 个体以及老年和年轻 HIV- 个体。 HIV+个体处于感染的早期和晚期症状阶段。在神经心理学表现、轻微认知运动障碍症状、免疫指标（CD4/CD8 比率；CD4 细胞计数；CD8 细胞计数）和血浆病毒载量方面观察到与老年依赖于 HIV 血清状态的关联。续约的重点是根据教育水平、种族和社会经济地位的匹配策略额外招募 95 名参与者。这些参与者将加入原始队列的纵向随访，并使用扩展的 N P 电池检查神经心理学表现的变化，增加工作记忆领域以及增加运动领域的评估。同样，我们还将研究轻微认知运动障碍的诊断和症状与年龄相关的影响。问题还将针对新提出的成果衡量标准。最初的研究目标是总体功能状态的差异，现在将更加集中于检查特定的认知功能状态（认知运动障碍的定义标准）。将继续研究与年龄相关的免疫学变化（CD4/CD8 比率、CD4 细胞计数和 CD8 细胞计数）的结果。将计数CD4细胞的初始亚群，并对CD4细胞的Th1和Th2亚群产生的细胞因子进行定量。关于我们在老年 HIV+ 个体中观察到的 CD8 细胞计数与年龄相关的增加，将列举 CD8 细胞的细胞毒性 T 淋巴细胞亚群。由于观察到的与年龄相关的免疫变化不是由血浆病毒载量介导的，因此将检查 HIV-1 蛋白表达以及已知与认知运动障碍和障碍相关的促炎细胞因子的相关产生。控制变量一直集中在使用数据缩减策略。这些发现可能对老年艾滋病毒感染者的管理具有很大的临床意义。