Skip to main content

Advertisement

SpringerLink
Log in

The Neuropsychology of HIV/AIDS in Older Adults

  • Review
  • Published:
Neuropsychology Review Aims and scope Submit manuscript

Abstract

Highly active antiretroviral therapy is allowing increasing numbers of adults to age with HIV. The neuropsychological effects of aging with HIV are reviewed through three types of studies. First, the separate effects of HIV and aging on cognition are examined in studies that compare younger adults with HIV with neurologically normal older adults. Second, studies examine the impact of aging within samples of adults with HIV only. Third, providing the most critical evidence, are studies that assess cognition in younger and older adults with HIV relative to younger and older adults without HIV. In general research findings are inconclusive. Large individual differences among older adults with HIV as well as co-factors (APOE4 and detectable viral load) may account for inconsistent findings in the literature. A subgroup of older adults with HIV may be at greater risk for cognitive impairment, especially in attention functioning.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  • Arendt, G., Hefter, H., Nelles, H. W., Hilperath, F., & Strohmeyer, G. (1993). Age-dependent decline in cognitive information processing of HIV-positive individuals detected by event-related potential recordings. Journal of the Neurological Sciences, 115, 223–229. doi:10.1016/0022-510X(93)90229-R.

    Article  CAS  PubMed  Google Scholar 

  • Barclay, T. R., Hinkin, C. H., Castellon, S. A., Mason, K. I., Reinhard, M. J., Marion, S. D., et al. (2007). Age-associated predictors of medication adherence in HIV-positive adults: health beliefs, self-efficacy, and neurocognitive status. Health Psychology, 26, 40–49. doi:10.1037/0278-6133.26.1.40.

    Article  PubMed  Google Scholar 

  • Bashore, T. R. (1993). Differential effects of aging on the neurocognitive functions subserving speeded mental processing. In J. Cerella, J. Rybash, W. Hoyer, & M. L. Commons (Eds.), Adult information processing: Limits on loss (pp. 37–76). San Diego: Academic Press.

    Google Scholar 

  • Becker, J. T., Sanchez, J., Dew, M. A., Lopez, O. L., Dorst, S. K., & Banks, G. (1997). Neuropsychological abnormalities among HIV-infected individuals in a community-based sample. Neuropsychology, 11, 592–601. doi:10.1037/0894-4105.11.4.592.

    Article  CAS  PubMed  Google Scholar 

  • Becker, J. T., Lopez, O. L., Dew, M. A., & Aizenstein, H. J. (2004). Prevalence of cognitive disorders differs as a function of age in HIV virus infection. AIDS (London, England), 18, 11–18. doi:10.1097/00002030-200401001-00003.

    Google Scholar 

  • Beer, J. S., Shimamura, A. P., & Knight, R. T. (2004). Frontal lobe contributions to executive control of cognitive and social behavior. In M. S. Gazzaniga (Ed.), The cognitive neurosciences, 3rd edn (pp. 1091–1104). Cambridge: MIT Press.

    Google Scholar 

  • Brew, B. J. (2004). Evidence for a change in AIDS dementia complex in the era of highly active antiretroviral therapy and the possibility of new forms of AIDS dementia complex. AIDS (London, England), 18, 75–78. doi:10.1097/00002030-200401001-00011.

    Google Scholar 

  • Centers for Disease Control and Prevention. (2007). Estimated numbers of persons living with HIV/AIDS, by year and selected characteristics, 2001–2004. Cited at www.cdc.gov/hiv/topics/surveillance/resources/reports/2004report/table8.htm.

  • Cherner, M., Ellis, R. J., Lazzaretto, D., Young, C., Mindt, M. R., Atkinson, J. H., et al. (2004). Effects of HIV-1 infection and aging on neurobehavioral functioning: preliminary findings. AIDS (London, England), 18, 27–34. doi:10.1097/00002030-200401001-00005.

    Google Scholar 

  • Comstock, J. R., & Arnegard, R. J. (1992). The multi-attribute task battery for human operator workload and strategic behavior research (Tech. Memorandum No. 104174). Hampton: NASA Langley Research Center.

    Google Scholar 

  • Concha, M., Graham, N. M. H., Munoz, A., Vlahov, D., Royal, W., Updike, M., et al. (1992). Effect of chronic substance abuse on the neuropsychological performance of intravenous drug users with a high prevalence of HIV-1 seropositivity. American Journal of Epidemiology, 136, 1338–1348.

    CAS  PubMed  Google Scholar 

  • Conigliaro, J., Justice, A. C., Gordon, A. J., & Bryant, K. (2006). Role of alcohol in determining human immunodeficiency virus (HIV)-relevant outcomes: a conceptual model to guide the implementation of evidence-based interventions into practice. Medical Care, 44, 1–6. doi:10.1097/01.mlr.0000223659.36369.cf.

    Article  Google Scholar 

  • Connor, M. D., Lammie, G. A., Bell, J. E., Warlow, C. P., Simmonds, P., & Brettle, R. D. (2000). Cerebral infarction in adult AIDS patients: observation from the Edinburgh HIV autopsy cohort. Stroke, 31, 2117–2126.

    CAS  PubMed  Google Scholar 

  • Cook, R. L., Sereika, S. M., Hunt, S. C., Woodward, W. C., Erlen, J. A., & Conigliaro, J. (2001). Problem drinking and medication adherence among persons with HIV infection. Journal of General Internal Medicine, 16, 83–88. doi:10.1111/j.1525-1497.2001.00122.x.

    Article  CAS  PubMed  Google Scholar 

  • Craik, F. I. M., & Salthouse, T. A. (Eds.), (1992). The handbook of aging and cognition. Hillsdale, NJ: Lawrence Erlbaum and Associates.

  • Craik, F. I. M., & Salthouse, T. A. (Eds.), (2000). The handbook of aging and cognition (2nd ed.). Hillsdale, NJ: Lawrence Erlbaum and Associates.

  • Czigler, I., Csibra, G., & Ambro, A. (1997). Age and information processing: event-related potential studies. European Psychologist, 2, 247–257. doi:10.1027/1016-9040.2.3.247.

    Article  Google Scholar 

  • El Yagoubi, R., Lemaire, P., & Besson, M. (2005). Effects of aging on arithmetic problem-solving: an even-related brain potential study. Journal of Cognitive Neuroscience, 17, 37–50. doi:10.1162/0898929052880084.

    Article  PubMed  Google Scholar 

  • Ernst, T., & Chang, L. (2004). Effect of aging on brain metabolism in antiretroviral-naïve HIV patients. AIDS (London, England), 18, 61–67. doi:10.1097/00002030-200401001-00009.

    Google Scholar 

  • Fama, R., Pfefferbaum, A., & Sullivan, E. V. (2004). Perceptual learning in detoxified alcoholic men: contributions from explicit memory, executive function, and age. Alcoholism, Clinical and Experimental Research, 28, 1657–1665. doi:10.1097/01.ALC.0000145690.48510.DA.

    Article  PubMed  Google Scholar 

  • Fama, R., Eisen, J. C., Rosenbloom, M. J., Sassoon, S. A., Kemper, C. A., Deresinski, S., et al. (2007). Upper and lower limb motor impairments in alcoholism, HIV infection, and their comorbidity. Alcoholism, Clinical and Experimental Research, 31, 1038–1044. doi:10.1111/j.1530-0277.2007.00385.x.

    Article  PubMed  Google Scholar 

  • Galvan, F. H., Bing, E. G., Fleishman, J. A., London, A. S., Caetano, R., Burnam, M. A., et al. (2002). The prevalence of alcohol consumption and heavy drinking among people with HIV in the United States: results from the HIV Cost and Services Utilization Study. Journal of Studies on Alcohol, 63, 179–186.

    PubMed  Google Scholar 

  • Gordon, S. M., Kennedy, B. P., & McPeake, J. D. (1988). Neuropsychologically impaired alcoholics: assessment, treatment considerations, and rehabilitation. Journal of Substance Abuse Treatment, 5, 99–104. doi:10.1016/0740-5472(88)90019-0.

    Article  CAS  PubMed  Google Scholar 

  • Gottlieb, M. S., Schanker, H. M., Fan, P. T., Saxon, A., Weisman, J. D., & Pozalski, I. (1981). Pneumocystis pneumonia—Los Angeles. Morbidity and Mortality Weekly Report, 30(21), 1–3.

    Google Scholar 

  • Grant, I., & Martin, A. (1994). Neuropsychology of HIV infection. New York: Oxford University Press.

    Google Scholar 

  • Grassi, M. P., Clerci, F., Perin, C., Zocchetti, C., Borella, M., Cargnel, A., & Mangoni, A. (1995). HIV infection and drug use: influence on cognitive function. AIDS (London, England), 9, 165–170. doi:10.1097/00002030-199509020-00008.

    CAS  Google Scholar 

  • Grotemeyer, K. H., Husstedt, I. W., Brundermann, H., Busch, H., Schlake, H. P., & Zidek, W. (1991). Event-related potentials in HIV-infected outpatients. AIDS Research and Human Retroviruses, 7, 629–635.

    Article  CAS  PubMed  Google Scholar 

  • Hardy, D. J., Hinkin, C. H., Satz, P., Stenquist, P. K., van Gorp, W. G., & Moore, L. H. (1999). Age differences and neurocognitive performance in HIV-infected adults. New Zealand Journal of Psychology, 28, 94–101.

    Google Scholar 

  • Hardy, D. J., Satz, P., Stefaniak, M., van Gorp, W. G., Hinkin, C. H., & Stenquist, P. K. (1999). Cognition in older adults with AIDS. Poster presented at the 4th Annual UCLA Research Conference on Aging.

  • Hardy, D. J., Borghi, S., Lodato, J., Zolnikof, B., Miller, E. N., Green, M., et al. (2004). Older HIV-infected adults and multi-task performance. Poster presented at the 24th Annual Conference of the National Academy of Neuropsychology, Seattle, Washington.

  • Hartley, A. A. (1992). Attention. In F. I. M. Craik, & T. A. Salthouse (Eds.), The handbook of aging and cognition (pp. 3–49). Hillsdale: Lawrence Erlbaum Associates.

    Google Scholar 

  • Heaton, R. K., Grant, I., Butters, N., White, D. A., Kirson, D., Atkinson, J. H., et al. (1995). The HNRC 500—Neuropsychology of HIV infection at different disease stages. Journal of the International Neuropsychological Society, 1, 231–251.

    Article  CAS  PubMed  Google Scholar 

  • Heaton, R. K., Grant, I., & Matthews, C. G. (1986). Differences in neuropsychological test performance associated with age, education and sex. In I. Grant, & K. M. Adams (Eds.), Neuropsychological Assessment of Neuropsychiatric Disorders (pp. 100–120). New York: Oxford University Press.

    Google Scholar 

  • Hicks, L. H., & Birren, J. E. (1970). Aging, brain damage, and psychomotor slowing. Psychological Bulletin, 74, 377–396. doi:10.1037/h0033064.

    Article  CAS  PubMed  Google Scholar 

  • Hinkin, C. H., Cummings, J. L., van Gorp, W. G., Satz, P., Mitrushina, M., & Freeman, D. (1990). Frontal/subcortical features of normal aging: an empirical analysis. Canadian Journal on Aging, 9, 104–119.

    Google Scholar 

  • Hinkin, C. H., Castellon, S. A., van Gorp, W. G., & Satz, P. (1998). Neuropsychological features of HIV disease. In W. G. van Gorp, & S. L. Buckingham (Eds.), Practitioner’s guide to the neuropsychiatry of HIV/AIDS (pp. 1–41). New York: The Guilford Press.

    Google Scholar 

  • Hinkin, C. H., Castellon, S. A., Atkinson, J. H., & Goodkin, K. (2001). Neuropsychiatric aspects of HIV infection among older adults. Journal of Clinical Epidemiology, 54, 44–52. doi:10.1016/S0895-4356(01)00446-2.

    Article  Google Scholar 

  • Hinkin, C. H., Hardy, D. J., Mason, K. I., Castellon, S. A., Durvasula, R. S., Lam, M. N., & Stefaniak, M. (2003). Medication adherence in HIV-infected adults: effect of patient age, cognitive status, and substance abuse. AIDS (London, England), 17, 1–7. doi:10.1097/00002030-200301030-00003.

    Google Scholar 

  • Justice, A. C., McGinnis, K. A., Atkinson, J. H., Heaton, R. K., Young, C., Sadek, J., et al. (2004). Psychiatric and neurocognitive disorders among HIV-positive and negative veterans in care: veterans Aging Cohort Five-Site Study. AIDS (London, England), 18, 49–59. doi:10.1097/00002030-200401001-00008.

    Google Scholar 

  • Linnville, S. E., Elliott, F. S., & Larson, G. E. (1996). Event-related potentials as indices of subclinical neurological differences in HIV patients during rapid decision making. The Journal of Neuropsychiatry and Clinical Neurosciences, 8, 293–304.

    CAS  PubMed  Google Scholar 

  • Mahncke, H. W., Bronstone, A., & Merzenich, M. M. (2006). Brain plasticity and functional losses in the aged: scientific bases for novel intervention. Progress in Brain Research, 157, 81–109. doi:10.1016/S0079-6123(06)57006-2.

    Article  PubMed  Google Scholar 

  • Marcotte, T. D., Heaton, R. K., Wolfson, T., Taylor, M. J., Alhassoon, O., Arfaa, K., et al. (1999). The impact of HIV-related neuropsychological dysfunction on driving behavior. Journal of the International Neuropsychological Society, 5, 579–592. doi:10.1017/S1355617799577011.

    Article  CAS  PubMed  Google Scholar 

  • Marcotte, T. D., Wolfson, T., Rosenthal, T. J., Heaton, R. K., Gonzalez, R., Ellis, R. J., et al. (2004). A multimodal assessment of driving performance in HIV infection. Neurology, 63, 1417–1422.

    CAS  PubMed  Google Scholar 

  • Marcotte, T. D., Lazzaretto, D., Scott, J. C., Roberts, E., Woods, S. P., Letendre, S., et al. (2006). Visual attention deficits are associated with driving accidents in cognitively-impaired HIV-infected individuals. Journal of Clinical and Experimental Neuropsychology, 28, 13–28. doi:10.1080/13803390490918048.

    Article  PubMed  Google Scholar 

  • McArthur, J. C., & Grant, I. (1998). HIV neurocognitive disorders. In H. E. Gendelman, S. A. Lipton, L. Epstein, & S. Swindells (Eds.), The neurology of AIDS (pp. 499–523). New York: Chapman & Hall.

    Google Scholar 

  • Nelson, E. A., & Dannefer, D. (1992). Aged heterogeneity: fact or fiction? The fate of diversity in gerontological research. The Gerontologist, 32, 17–23. doi:10.1159/000116781.

    CAS  PubMed  Google Scholar 

  • Parasuraman, R., & Haxby, J. V. (1993). Attention and brain function in Alzheimer’s Disease. Neuropsychology, 7, 242–272. doi:10.1037/0894-4105.7.3.242.

    Article  Google Scholar 

  • Parasuraman, R., Greenwood, P. M., & Sunderland, T. (2002). The apolipoprotein E gene, attention, and brain function. Neuropsychology, 16, 254–274. doi:10.1037/0894-4105.16.2.254.

    Article  PubMed  Google Scholar 

  • Pfefferbaum, A., Ford, J. M., Wenegrat, B. G., Roth, W. T., & Kopell, B. S. (1984). Clinical application of the p3 component of event-related potentials. I. Normal aging. Electroencephalography and Clinical Neurophysiology, 59, 85–103. doi:10.1016/0168-5597(84)90026-1.

    Article  CAS  PubMed  Google Scholar 

  • Pfefferbaum, A., Adalsteinsson, E., & Sullivan, E. V. (2005). Cortical NAA deficits in HIV infection without dementia: influence of alcoholism comorbidity. Neuropsychopharmacology, 30, 1392–1399. doi:10.1038/sj.npp.1300623.

    Article  CAS  PubMed  Google Scholar 

  • Picton, T. W., Stuss, D. T., Champagne, S. C., & Nelson, R. F. (1984). The effects of age on human event-related potentials. Psychophysiology, 21, 312–325. doi:10.1111/j.1469-8986.1984.tb02941.x.

    Article  CAS  PubMed  Google Scholar 

  • Polich, J., Ilan, A., Poceta, J. S., Mitler, M. M., & Darko, D. F. (2000). Neuroelectric assessment of HIV: EEG, ERP, and viral load. International Journal of Psychophysiology, 38, 97–108. doi:10.1016/S0167-8760(00)00133-1.

    Article  CAS  PubMed  Google Scholar 

  • Raz, N., & Rodrigue, K. M. (2006). Differential aging of the brain: patterns, cognitive correlates and modifiers. Neuroscience and Biobehavioral Reviews, 30, 730–748. doi:10.1016/j.neubiorev.2006.07.001.

    Article  PubMed  Google Scholar 

  • Rugg, M. D., & Coles, M. G. H. (Eds.), (1995). Electrophysiology of mind. Oxford: Oxford University Press.

  • Salthouse, T. A. (1994). How many causes are there of aging-related decrements in cognitive functioning? Developmental Review, 14, 413–437. doi:10.1006/drev.1994.1016.

    Article  Google Scholar 

  • Sassoon, S. A., Fama, R., Rosenbloom, M. J., O’Reilly, A., Pfefferbaum, A., & Sullivan, E. V. (2007). Component cognitive and motor processes of the Digit Symbol Test: differential deficits in alcoholism, HIV infection, and their comorbidity. Alcoholism, Clinical and Experimental Research, 31, 1315–1324. doi:10.1111/j.1530-0277.2007.00426.x.

    Article  PubMed  Google Scholar 

  • Schaie, K. W. (1996). Intellectual development in adulthood. In J. E. Birren, & K. W. Schaie (Eds.), Handbook of the psychology of aging, 4th edn (pp. 266–286). San Diego: Academic Press.

    Google Scholar 

  • Stern, Y. (1994). Neuropsychological assessment of seropositive intravenous drug users. In I. Grant, & A. Martin (Eds.), Neuropsychology of HIV infection (pp. 220–233). New York: Oxford University Press.

    Google Scholar 

  • Stoff, D. M. (2004). Mental health research in HIV/AIDS and aging: problems and prospects. AIDS (London, England), 18, 3–10. doi:10.1097/00002030-200401001-00002.

    Google Scholar 

  • Stoff, D. M., Khalsa, J. H., Monjan, A., & Portegies, P. (2004). Introduction: HIV/AIDS and aging. AIDS (London, England), 18, 1–2. doi:10.1097/00002030-200401001-00001.

    Google Scholar 

  • Takakuwa, K. M., Callaway, E., Naylor, H., Herzig, K. E., & Yano, L. M. (1993). The effects of the Human Immunodeficiency Virus on visual information processing. Biological Psychiatry, 34, 194–197. doi:10.1016/0006-3223(93)90392-Q.

    Article  CAS  PubMed  Google Scholar 

  • Tartar, J. L., Sheehan, C. M., Nash, A. J., Starratt, C., Puga, A., & Widmayer, S. (2004). ERPs differ from neurometric tests in assessing HIV-associated cognitive deficit. Neuroreport, 15, 1675–1678. doi:10.1097/01.wnr.0000134992.74181.4b.

    Article  PubMed  Google Scholar 

  • Valcour, V., Shikuma, C., Shiramizu, M., Watters, M., Poff, P., Selnes, O. A., et al. (2004). Age, apolipoprotein E4, and the risk of HIV dementia: the Hawaii Aging with HIV Cohort. Journal of Neuroimmunology, 157, 197–202. doi:10.1016/j.jneuroim.2004.08.029.

    Article  CAS  PubMed  Google Scholar 

  • Valcour, V. G., Shikuma, C. M., Watters, M. R., & Sactor, N. C. (2004). Cognitive impairment in older HIV-1-seropositive individuals: prevalence and potential mechanisms. AIDS (London, England), 18, 79–86. doi:10.1097/00002030-200401001-00012.

    Google Scholar 

  • Valcour, V., Shikuma, C., Shiramizu, B., Watters, M., Poff, P., Selnes, O., et al. (2006). Higher frequency of dementia in older HIV-1 individuals. The Hawaii Aging with HIV-1 Cohort. Neurology, 63, 822–827.

    Google Scholar 

  • van Gorp, W. G., & Mahler, M. (1990). Subcortical features of normal aging. In J. L. Cummings (Ed.), Subcortical dementia (pp. 231–250). New York: Oxford University Press.

    Google Scholar 

  • van Gorp, W. G., Mitrushina, M., Cummings, J. L., Satz, P., & Modesitt, J. (1989). Normal aging and the subcortical encephalopathy of AIDS. A neuropsychological comparison. Neuropsychiatry, Neuropsychology, and Behavioral Neurology, 2, 5–20.

    Google Scholar 

  • van Gorp, W. G., Miller, E. N., Marcotte, T. D., Dixon, W., Paz, D., Selnes, O., et al. (1994). The relationship between age and cognitive impairment in HIV-1 infection: findings from the Multicenter AIDS Cohort Study and a clinical cohort. Neurology, 44, 929–935.

    PubMed  Google Scholar 

  • Vance, D. E. (2004). Cortical and subcortical dynamics of aging with HIV infection. Perceptual and Motor Skills, 98, 647–655. doi:10.2466/PMS.98.2.647-655.

    Article  PubMed  Google Scholar 

  • Vance, D. E., & Robinson, F. P. (2004). Reconciling successful aging with HIV: a biopsychosocial overview. Journal of HIV/AIDS & Social Services, 3, 59–78. doi:10.1300/J187v03n01_06.

    Article  Google Scholar 

  • Vance, D. E., & Burrage Jr., J. W. (2006). Promoting successful cognitive aging in adults with HIV: strategies for intervention. Journal of Gerontological Nursing, 32(11), 34–41.

    PubMed  Google Scholar 

  • Vance, D. E., Woodley, R. A., & Burrage Jr., J. A. (2007). Predictors of cognitive ability in adults aging with HIV: a pilot study. Clinical Gerontologist, 30(3), 83–101. doi:10.1300/J018v30n03_07.

    Article  Google Scholar 

  • West, R., & Schwarb, H. (2006). The influence of aging and frontal function on the neural correlates of regulative and evaluative aspects of cognitive control. Neuropsychology, 20, 468–481. doi:10.1037/0894-4105.20.4.468.

    Article  PubMed  Google Scholar 

  • Wilkie, F. L., Goodkin, K., Khamis, I., van Zuilen, M. H., Lee, D., Lecusy, R., et al. (2003). Cognitive functioning in younger and older HIV-1-infected adults. Journal of Acquired Immune Deficiency Syndromes, 33, 93–105.

    Google Scholar 

  • Woodruff-Pak, D. S. (1997). The neuropsychology of aging. Malden: Blackwell Publishers Inc.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Psychology, Loyola Marymount University, Los Angeles, CA, USA

    David J. Hardy

  2. Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, CA, USA

    David J. Hardy

  3. School of Nursing, University of Alabama at Birmingham, Birmingham, AL, USA

    David E. Vance

Authors
  1. David J. Hardy
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. David E. Vance
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to David J. Hardy.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Hardy, D.J., Vance, D.E. The Neuropsychology of HIV/AIDS in Older Adults. Neuropsychol Rev 19, 263–272 (2009). https://doi.org/10.1007/s11065-009-9087-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11065-009-9087-0

Keywords

Search

Navigation