Department of Psychology, University of Houston, 126 Heyne Building, Houston, TX, 77004, USA.
Department of Psychiatry, University of California, San Diego, CA, USA.
J Neurovirol. 2019 Apr;25(2):162-173. doi: 10.1007/s13365-018-0699-0. Epub 2018 Dec 10.
Age and HIV disease have additive effects on neural systems that support motor functioning. The current study examined the combined impact of aging and HIV on extrapyramidal motor functions, which were hypothesized to influence on activities of daily living (ADLs) and quality of life (QoL). Participants included 336 adults classified by HIV serostatus and age. A research nurse administered the Unified Parkinson's Disease Rating Scale (UPDRS) and participants completed the modified Lawton & Brody ADL and the Short Form Survey Instrument (SF-36) questionnaires as part of a larger neuropsychological research battery. A convenience subset of 172 participants completed a 14-month follow-up evaluation. At baseline, only older age was associated with mild extrapyramidal signs; however, at 14-month follow-up, independent adverse effects of both HIV status and age group were observed on a 3-level UPDRS change variable. Among older HIV+ adults, the presence of mild UPDRS motor signs was independently associated with basic and instrumental ADL dependence, as well as lower physical (ps < .05), but not mental QoL. In the modern treatment era, older HIV+ adults show higher frequency of mild extrapyramidal signs as compared to younger individuals (but not older HIV- persons) and are at higher risk of incident extrapyramidal signs relative to HIV- persons (but not younger HIV+ persons). When present in older HIV+ adults, extrapyramidal signs are of mild severity but nevertheless increase the risk of daily functioning problems and lower health-related physical QoL.
年龄和 HIV 疾病对支持运动功能的神经系统有累加效应。本研究考察了衰老和 HIV 对锥体外系运动功能的综合影响，这些功能被假设会影响日常生活活动（ADL）和生活质量（QoL）。参与者包括根据 HIV 血清状况和年龄分类的 336 名成年人。一名研究护士进行了统一帕金森病评定量表（UPDRS）评估，参与者完成了改良的 Lawton & Brody ADL 和简明健康状况调查量表（SF-36）问卷，作为更大神经心理学研究工具包的一部分。172 名参与者的便利子样本完成了为期 14 个月的随访评估。在基线时，只有年龄较大与轻微锥体外系迹象相关；然而，在 14 个月的随访时，HIV 状况和年龄组的独立不利影响观察到在 UPDRS 变化变量的 3 个水平上。在年龄较大的 HIV+成年人中，轻度 UPDRS 运动迹象的存在与基本和工具性 ADL 依赖独立相关，以及较低的身体（p<.05），但不是心理健康 QoL。在现代治疗时代，与年轻个体相比，年龄较大的 HIV+成年人表现出更高频率的轻微锥体外系迹象（但不比年龄较大的 HIV-个体高），并且与 HIV-个体相比，发生锥体外系迹象的风险更高（但不比年轻的 HIV+个体高）。当存在于年龄较大的 HIV+成年人中时，锥体外系迹象的严重程度较轻，但仍会增加日常生活功能问题的风险，并降低与健康相关的身体 QoL。
