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Aging Accelerates Postural Instability in HIV Infection: Contributing Sensory Biomarkers

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Abstract

People living with HIV infection (PWH) who are adequately treated pharmacologically are now likely to have a near normal life span. Along with this benefit of the aging HIV population are potential physical problems attendant to aging, including postural stability. Whether aging with HIV accelerates age-related liability for postural instability and what sensory factors contribute to imbalance were examined in 227 PWH and 137 people living without HIV (PWoH), age 25 to 75 years. A mixed cross-sectional/longitudinal design revealed steeper aging trajectories of the PWH than PWoH in sway path length, measured as center-of-pressure micro-displacements with a force platform while a person attempted to stand still. Sway paths were disproportionately longer for PWH than PWoH when tested with eyes closed than open. Multiple regression identified objective measures of sensory perception as unique predictors of sway path length, whereas age, sway path length, and self-reports of falls were predictors of standing on one leg, a common measure of ataxia. Knowledge about sensory signs and symptoms of imbalance in postural stability with and without visual information may serve as modifiable risk factors for averting instability and liability for falls in the aging HIV population.

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Availability of Data and Material

The data that support the findings of this study are available from the corresponding author upon reasonable request.

Code Availability

Statistical analysis was performed using freely available packages through R 3.5.1 [https://www.r-project.org/].

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Funding

This research was funded by grants from the National Institute on Alcohol Abuse and Alcoholism (AA017347, AA010723, AA005965).

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Authors and Affiliations

  1. Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, MC5723, 401 Quarry Road, Stanford, CA, USA

    Edith V. Sullivan, Natalie M. Zahr & Adolf Pfefferbaum

  2. Center for Health Sciences, SRI International, Menlo Park, CA, USA

    Edith V. Sullivan, Natalie M. Zahr, Stephanie A. Sassoon & Adolf Pfefferbaum

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  1. Edith V. Sullivan
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  2. Natalie M. Zahr
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  4. Adolf Pfefferbaum
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All authors participated in all aspects of this project: data collection, data analysis, manuscript writing, and editing.

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Correspondence to Edith V. Sullivan.

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This research project and all procedures were approved by the Institutional Review Boards of Stanford University School of Medicine and SRI International in accordance with the 1964 Declaration of Helsinki and its later amendments.

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Those volunteering for the study gave written informed consent at each test session for participation after reviewing the consent statements.

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All authors contributed significantly to this research project, and none has any conflict with this work. This work is not being considered for publication elsewhere.

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Sullivan, E.V., Zahr, N.M., Sassoon, S.A. et al. Aging Accelerates Postural Instability in HIV Infection: Contributing Sensory Biomarkers. J Neuroimmune Pharmacol 17, 538–552 (2022). https://doi.org/10.1007/s11481-021-10039-y

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