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A longitudinal view of successful aging with HIV: role of resilience and environmental factors

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Abstract

Purpose

The purpose of this study is to estimate the extent to which people aging with HIV meet criteria for successful aging as operationalized through HRQL and maintain this status over time. A second objective is to identify factors that place people at promise for continued successful aging, including environmental and resilience factors.

Methods

Participants were members of the Positive Brain Health Now (BHN) cohort. People ≥ 50 years (n = 513) were classified as aging successfully if they were at or above norms on 7 or 8 of 8 health-related quality of life domains from the RAND-36. Group-based trajectory analysis, regression tree analysis, a form of machine learning, and logistic regression were applied to identify factors predicting successful aging.

Results

73 (14·2%) met criteria for successful aging at entry and did not change status over time. The most influential factor was loneliness which split the sample into two groups with the prevalence of successful aging 28·4% in the “almost never” lonely compared to 4·6% in the “sometimes/often” lonely group. Other influential factors were feeling safe, social network, motivation, stigma, and socioeconomic status. These factors identified 17 sub-groups with at least 30 members with the proportions classified as aging successfully ranging from 0 to 79·4%. The nine variables important to classifying successful aging had a predictive accuracy of 0.862. Self-reported cognition but not cognitive test performance improved this accuracy to 0.895. The two groups defined by successful aging status did not differ on age, sex or viral load, nadir and current.

Conclusion

The results indicate the important role of social determinants of health in successful aging among people living with HIV.

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Funding

This project was supported by grants from the Canadian Institutes of Health Research (LKF, MJB, NM, TCO-125272), the CIHR Canadian HIV Trials Network (CTN 273), and salary support from the Fonds de Recherche Santé du Québec (LKF) and the Research Institute of the McGill University Health Centre (MJB). None of these funding agencies played any role in the design, data collection, analysis or interpretation of the study.

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Authors and Affiliations

Authors

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Contributions

NEM: conception of project, supervision of analysis, drafted the paper, tables and figures, verified accuracy of all data in the paper, made edits to paper based on co-authors comments. MJB: recruitment of participants, interpretation of results, editorial comments to paper. LN: carried out the analysis under supervision of NM an ND; verified accuracy of all data in the paper, editorial comments on the paper. ND: provided guidance on the data analysis, provided comments on the paper. MH, recruitment of participants, interpretation of results, editorial comments to paper. FS, recruitment of participants, interpretation of results, editorial comments to paper. GS, recruitment of participants, interpretation of results, editorial comments to paper. RT, recruitment of participants, interpretation of results, editorial comments to paper. LK, interpretation of results, editorial comments to paper.

Corresponding author

Correspondence to Nancy E. Mayo.

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Conflict of interest

Authors declare that they have no conflicts of interest.

Ethical approval

All procedures performed were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The project was approved by the Research Ethics Board of each of the participating institutions.

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All participants provided informed consent.

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Mayo, N.E., Brouillette, MJ., Nadeau, L. et al. A longitudinal view of successful aging with HIV: role of resilience and environmental factors. Qual Life Res 31, 1135–1145 (2022). https://doi.org/10.1007/s11136-021-02970-7

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