AIDS and aging focus of research study

June 11, 2018, McGill University

When the general public thinks of HIV, they do not think of a neurological disease, yet people living with HIV infection know they need to worry about their brain health.

Untreated, HIV can cause severe dementia. Even with good control of the infection, a third or more of patients have problems with thinking or concentration, and many have mental challenges. These issues are of particular concern in those over 50, a rapidly expanding group given the success of modern antiretroviral treatment.

These problems can affect the ability to work, to engage fully in social and family roles, and to manage the medications required to treat the HIV infection. Yet the underlying causes, evolution over time, and best approaches to treatment remain unclear. Further, standard cognitive assessments are not widely available, making diagnosis more difficult. To address these gaps in knowledge, a multi-disciplinary team of researchers at The Montreal Neurological Institute and Hospital (The Neuro) and McGill University and the McGill University Health Centre Research Institute, together with scientists and physicians at other institutions in Montreal and across Canada, as well as members of the HIV community, created Action for Positive Brain Health Now. The goals of this project include developing better assessment tools, identifying factors that cause decline and defining the effects of this decline on function and quality of life.

The team recruited 856 older HIV-positive participants at five centres across Canada and measured their brain health. Participants will be followed regularly for six or more years, with detailed assessments of their general health, mood, day-to-day function and quality of life. The project is also testing several possible treatments to improve brain health, ranging from exercise, to cognitive rehabilitation, to treatment of sleep problems.

If people living with HIV who follow these interventions think more clearly and function better, that will help health practitioners make specific recommendations to improve brain health in the future. This research in older people with HIV may also teach us more about the factors that lead to brain changes and memory loss with age in the general population.

Already, research from the Positive Brain Health Now team has established that a third to a half of study participants experience one or more brain health difficulties. Impaired cognition or depression, or both, have a clear impact on social and occupational engagement and quality of life. Although symptoms are common, they are stable over the short-term in most people, and can even improve in some.

While HIV infection itself can lead to brain dysfunction, other factors may be as, or more, important. Poor vascular health may take an indirect toll on the brain by reducing blood flow, and social exclusion and stigmatization also affect both thinking and mood. This broader understanding of the factors contributing to brain health in HIV provides many more targets for intervention.

Early results from the intervention studies suggest that treatments such as cognitive rehabilitation or exercise training can make a difference. Future work will test whether social engagement can help as well. The Positive Brain Health Now team is developing computer apps to assess brain health quickly in the clinic, and to help patients understand their brain health strengths and weaknesses, and pinpoint the treatments that best target their unique risk factors.

"While we wait for the outcome of our study, we recommend that people living with HIV take particular care of their brain health: stop smoking, get regular exercise, and enough sleep," says Dr. Lesley Fellows, a neurologist at The Neuro and one of the project's three lead investigators. "Stay mentally active and engaged, whether at work, in a volunteer role, or through a hobby or social group. Minimize drugs or alcohol that might slow brain function. Eat a healthy diet with lots of vegetables, whole grains and fish. These are recommendations for everyone, but we think they are especially important steps to take if you live with HIV."

Co-lead Dr. Marie-Josée Brouillette, a psychiatrist at the McGill University Health Centre, emphasizes the importance of taking a holistic view of brain health. "Memory, concentration and mood are intertwined. Working on problems in one area of health may also address problems in other areas and improve overall function. Existing treatments and healthier behaviors can help, but people living with HIV need guidance to know where to start. This project should give them the tools they need."

Explore further: New 'brain health index' can predict how well patients will do after stroke

Related Stories

New 'brain health index' can predict how well patients will do after stroke

April 19, 2018
A new computer programme developed by scientists at the Universities of Edinburgh and Glasgow can assess whole brain deterioration and help predict cognitive function after stroke up to ten times more accurately than current ...

We can change our brain and its ability to cope with disease with simple lifestyle choices

April 24, 2018
Our life expectancy has increased dramatically over the past several decades, with advances in medical research, nutrition and health care seeing us live well into our 80s. But this longer life expectancy has also come at ...

Depression speeds up brain aging, find psychologists

May 24, 2018
Psychologists at the University of Sussex have found a link between depression and an acceleration of the rate at which the brain ages. Although scientists have previously reported that people with depression or anxiety have ...

Early HIV treatment key to avoiding brain atrophy

May 3, 2018
While the human immunodeficiency virus (HIV) has largely dropped from news headlines since the 1990s, at the end of 2016 there were 36.7 million people living with the infection, and of those only 53 per cent had access to ...

Q&A: Lifelong strategies for preventing dementia

November 17, 2017
Dear Mayo Clinic: Do puzzles and other activities or apps that claim to lower one's risk of developing dementia actually work? Are there other things people can do to decrease the risk?

Can 'sleeping' while you're awake boost brain function?

January 3, 2018
Mimicking sleep processes in the awake brain of elderly people could prevent age-related decline in brain function.

Recommended for you

CRISPR technology targets mood-boosting receptors in brain

August 17, 2018
An estimated 13 percent of Americans take antidepressant drugs for depression, anxiety, chronic pain or sleep problems. For the 14 million Americans who have clinical depression, roughly one third don't find relief with antidepressants.

People are more honest when using a foreign tongue, research finds

August 17, 2018
New UChicago-led research suggests that someone who speaks in a foreign language is probably more credible than the average native speaker.

Critical role of DHA on foetal brain development revealed

August 17, 2018
Duke-NUS researchers have found evidence that a natural form of Docosahexaenoic Acid (DHA) made by the liver called Lyso-Phosphatidyl-Choline (LPC-DHA), is critical for normal foetal and infant brain development, and that ...

Automated detection of focal epileptic seizures in a sentinel area of the human brain

August 17, 2018
Patients with focal epilepsy that does not respond to medications badly need alternative treatments.

Men and women show surprising differences in seeing motion

August 16, 2018
Researchers reporting in the journal Current Biology on August 16 have found an unexpected difference between men and women. On average, their studies show, men pick up on visual motion significantly faster than women do.

Brain response study upends thinking about why practice speeds up motor reaction times

August 16, 2018
Researchers in the Department of Physical Medicine and Rehabilitation at Johns Hopkins Medicine report that a computerized study of 36 healthy adult volunteers asked to repeat the same movement over and over became significantly ...


Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.