Cognitive efficiency is considered a foundational component of successful ageing with HIV. It underlies other important aspects such as length of life, biological health, mental health, personal control, social competence, productivity, and individual differences/quality of life. By improving cognitive efficiency, overall successful ageing can be fostered in people with HIV (PWH).
The importance of addressing cognitive impairments in PWH and promoting successful ageing lies in several key factors. First, the number of PWH aged 50 and older is increasing. For example, in the United States around 50% of PWH fall into this age group, and it is projected to rise to 70% by 2030. This is a trend observed in other countries as well. This demographic shift highlights the need to focus on the unique challenges faced by older adults with HIV. Second, HIV-Associated Neurocognitive Disorder (HAND), an umbrella term which can include HIV-related neurocognitive impairment, occurs in many PWH and can impact various aspects of daily life, including driving, medication adherence, and financial management. Addressing suboptimal cognitive functioning is crucial to mitigate these functional limitations and enhance quality of life. And third, as PWH age, they are more likely to develop age-related comorbidities such as heart disease, diabetes, and hypertension. These conditions can further affect brain health and cognition. Therefore, protecting and enhancing cognitive function becomes even more vital in the context of multiple comorbidities.
The goal of this Article Collection is to solicit original research, secondary analyses, and thoughtful integrative reviews that expound on the topic of cognitive functioning in PWH, especially as they age. Recently Nightingale and colleagues suggested that as clinician scientists we should be examining all cause cognitive impairment in PWH, not just HIV-related causes (active and legacy effects) although also important. This approach is divergent from the HIV only causal focused criteria for HAND. Thus, articles focused on all cause cognitive impairment are encouraged. Furthermore, several topics for research in this area are suggested, such as successful sensory and cognitive ageing, cognitive interventions, occupational and everyday functioning, the influence of hot cognition on social cognition, the impact of vision impairment on cognitive decline, and the interrelationship between olfactory function and cognition, all contribute to a comprehensive understanding of cognitive functioning in PWH. Specific questions to be answered include: What are the correct of best screening tools? What’s the natural history of cognitive functioning in PWH as they age? How can we intervene to protect or improve cognition in PWH? How do we ensure global equity in providing clinical care of cognition in PWH? These topics offer avenues for exploring strategies to preserve and enhance cognitive function in PWH, ultimately supporting successful ageing outcomes.
Dr. David E. Vance is a Professor in the University of Alabama at Birmingham (UAB) School of Nursing and psychologist actively pursuing research in cognitive intra-individual variability, positive and negative neuroplasticity, neurocognitive aging, neurocognitive remediation, aging with HIV, and more recently neurocognition in cancer survivors. With a passion for successful cognitive aging and for mentoring scientific leaders, Dr. Vance’s work has resulted in +370 publications including +290 peer-reviewed articles as well as numerous book chapters and editorials and has disseminated his research prolifically in +365 national and international presentations across 22 countries/territories. He has been awarded several research grants in which has studied interventions to improve cognitive functioning in middle-aged and older adults with HIV.
