scholarly journals Links between inflammation, mood, and physical function among older adults with HIV

2021 ◽  
Author(s):  
Heather M Derry ◽  
Carrie D Johnston ◽  
Chelsie O Burchett ◽  
Mark Brennan-Ing ◽  
Stephen Karpiak ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Physical Function ◽  
Psychosocial Factors ◽  
Inflammatory Markers ◽  
People Living With Hiv ◽  
Cross Sectional ◽  
Reactive Protein ◽  
Age Related ◽  
Cytokine Levels ◽  
Key Factor

Abstract Objectives People living with HIV (PLWH) treated with antiretrovirals have lifespans similar to their HIV-negative peers. Yet, they experience elevated inflammation-related multi-morbidity. Drawing on biopsychosocial determinants of health may inform interventions, but these links are understudied in older PLWH. We investigated cross-sectional relationships between psychosocial factors (mood, loneliness, and stigma), inflammatory markers, and age-related health outcomes among 143 PLWH ages 54 to 78 years. Methods Participants provided blood samples for serum cytokines and C-reactive protein (CRP), completed surveys assessing psychosocial factors and health, and completed frailty assessments. Regression models tested relationships between key psychosocial, inflammation, and age-related health variables, adjusting for relevant sociodemographic and clinical factors. Results Participants with more depressive symptoms had higher composite cytokine levels than those with fewer depressive symptoms (ß=0.22, t(126)=2.71, p=0.008). Those with higher cytokine levels were more likely to be prefrail or frail (adjusted OR=1.72, 95% CI=1.01 to 2.93) and reported worse physical function (ß= -0.23, t(129)= -2.64, p=0.009) and more cognitive complaints (ß= -0.20, t(129)= -2.16, p=0.03) than those with lower cytokine levels. CRP was not significantly related to these outcomes; six-month fall history was not significantly related to inflammatory markers. Discussion Novel approaches are needed to manage comorbidities and maximize quality of life among older PLWH. Illustrating key expected biopsychosocial links, our findings highlight several factors (e.g., depressive symptoms, poorer physical function) that may share bidirectional relationships with chronic inflammation, a key factor driving morbidity. These links may be leveraged to modify factors that drive excessive health risk among older PLWH.

scholarly journals Aging With HIV: Inflammation Is Associated With Pain, Poorer Physical Function, and Frailty

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 334-334
Author(s):  
Heather Derry ◽  
Carrie Johnston ◽  
Chelsie Burchett ◽  
Eugenia Siegler ◽  
Marshall Glesby
Keyword(s):  
Older Adults ◽  
Physical Function ◽  
Inflammatory Markers ◽  
Smoking Status ◽  
Well Being ◽  
People Living With Hiv ◽  
Cognitive Complaints ◽  
Age Related ◽  
Comorbidity Burden ◽  
Ifn Γ

Abstract With advances in antiretroviral therapies, people living with HIV have life expectancies similar to their HIV-negative peers. Yet, they experience elevated multi-morbidity that can compromise quality of life as they age. Links between inflammation and accelerated aging may inform interventions, but these links are understudied in older adults with HIV. We investigated cross-sectional relationships between inflammation, well-being, and geriatric syndromes among 161 HIV-positive older adults. Participants provided fasting blood samples (for serum cytokines and CRP) and completed surveys (MOS-HIV; falls) and cognitive (MoCA) and frailty assessments (using Fried criteria). Adjusted linear and logistic regression models tested relationships between inflammatory markers and age-related health outcomes, controlling for age, gender, BMI, race, comorbidity burden, statin use, and smoking status. 93% had suppressed viral load. 11% had CRP levels suggesting possible acute illness (>10 mg/L) and were excluded from analyses. Participants with higher IFN-γ reported greater pain (p=0.003), greater cognitive complaints (p=.02), and worse physical function (p=0.04), than those with lower IFN-γ. Similarly, higher IL-6 levels were related to worse physical function (p=0.01) and slightly greater cognitive complaints (p=0.06), but were not significantly related to pain in adjusted models. Compared to those with lower IL-6, those with higher IL-6 levels were more likely to be frail (p=0.04). CRP was not significantly related to these outcomes. Six-month fall history and objective cognitive scores were not significantly related to the assessed inflammatory markers. Our results illustrate key, expected links between inflammatory processes, frailty, physical function, and pain among older adults with HIV.

scholarly journals Stigma mastery in people living with HIV: gender similarities and theory

2021 ◽  
Author(s):  
Charles Patrick Namisi ◽  
John C. Munene ◽  
Rhoda K. Wanyenze ◽  
Anne R. Katahoire ◽  
Rosalinda M. Parkes-Ratanshi ◽  
...  
Keyword(s):  
Older Women ◽  
Social Exclusion ◽  
Theoretical Framework ◽  
People Living With Hiv ◽  
Negative Effects ◽  
Hiv Diagnosis ◽  
Cross Sectional ◽  
Age Related ◽  
Related Stigma ◽  
Living With Hiv

Abstract Aims This study aimed to determine the prevalence of, factors associated with, and to build a theoretical framework for understanding Internalsed HIV-related Stigma Mastery (IHSM). Methods A cross-sectional study nested within a 2014 Stigma Reduction Cohort in Uganda was used. The PLHIV Stigma Index version 2008, was used to collect data from a random sample of 666 people living with HIV (PLHIV) stratified by gender and age. SPSS24 with Amos27 softwares were used to build a sequential-mediation model. Results The majority of participants were women (65%), aged ≥ 40 years (57%). Overall, IHSM was 45.5% among PLHIV, that increased with age. Specifically, higher IHSM correlated with men and older women “masculine identities” self-disclosure of HIV-diagnosis to family, sharing experiences with peers. However, lower IHSM correlated with feminine gender, the experience of social exclusion stress, fear of future rejection, and fear of social intimacy. Thus, IHSM social exclusion with its negative effects and age-related cognition are integrated into a multidimensional IHSM theoretical framework with a good model-to-data fit. Conclusion Internalised HIV-related Stigma Mastery is common among men and older women. Specificially, “masculine identities” self-disclose their own HIV-positive diagnosis to their family, share experiences with peers to create good relationships for actualising or empowerment in stigma mastery. However, social exclusion exacerbates series of negative effects that finally undermine stigma mastery by young feminine identities. Thus, stigma mastery is best explained by an integrated empowerment framework, that has implications for future practice, policy, and stigma-related research that we discuss.

scholarly journals Analysis of inflammatory markers in patients with abnormal circadian rhythm of blood pressure

2021 ◽  
Author(s):  
Néstor Agra ◽  
Ana Teresa Afonso ◽  
Antón Sande ◽  
Ignacio Veleiro ◽  
José Enrique Paz ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Uric Acid ◽  
Circadian Rhythm ◽  
Inflammatory Markers ◽  
Antihypertensive Drugs ◽  
Cross Sectional ◽  
Reactive Protein ◽  
Inflammatory Status ◽  
Retrospective Data Analysis ◽  
Cross Sectional Design

IntroductionInflammatory status could play a role in alterations of blood pressure (BP) circadian rhythm. The aim of our study is to compare levels of usual inflammatory markers in patients with and without circadian BP abnormalities.Material and methodsThis is a cross-sectional design study with retrospective data analysis which included patients from an Internal Medicine Department with normal and high BP levels older than 18 years who were separated into two groups according to the circadian profile of BP (dipper and non-dipper) based on the results of 24-hour ambulatory BP monitoring. Patients were assessed for demographic characteristics and cardiovascular risk factors. We considered as inflammatory markers the platelet count (PTC), erythrocyte sedimentation rate (ESR), ultra-sensitive C-reactive protein, ferritin, fibrinogen, and uric acid.ResultsThe study included 551 patients (mean age of 54 years, 47% women). The non-dipper group had a higher percentage of individuals with higher ESR (OR = 1.77, 95% CI: 1.23–1.55, p = 0.001), uric acid (OR = 1.50, 95% CI: 1.04–2.16, p = 0.028) and fibrinogen (OR = 1.72, 95% CI: 1.18–2.51, p = 0.001) and a higher percentage of patients with higher PTC (OR = 0.54, 95% CI: 0.37–0.78, p = 0.005). These results were independent of age, waist circumference, presence of arterial hypertension, diabetes or hyperlipidemia, and use of antihypertensive drugs including renin angiotensin aldosterone system blockers.ConclusionsPatients with impaired circadian BP rhythm were associated with an unfavorable inflammatory status independently of BP levels. This fact could play a role in the prognostic differences observed between dipper and non-dipper patients.

scholarly journals An Analysis of Personal Learning Environments and Age-Related Psychosocial Factors of Unaccompanied Foreign Minors

2020 ◽  
Vol 17 (10) ◽  
pp. 3700 ◽  
Author(s):  
María Tomé-Fernández ◽  
Marina García-Garnica ◽  
Asunción Martínez-Martínez ◽  
Eva María Olmedo-Moreno
Keyword(s):  
Social Networks ◽  
Learning Environments ◽  
Psychosocial Factors ◽  
Social Inclusion ◽  
Cross Sectional ◽  
Personal Learning ◽  
Use Of Resources ◽  
Age Related ◽  
Personal Learning Environments ◽  
Unaccompanied Foreign Minors

Spain is one of the countries with the greatest influx of immigrants and, specifically, of unaccompanied foreign minors (UFMs). The educational and social inclusion of unaccompanied foreign minors poses both a challenge and a threat to current policy. Nonetheless, studies linking educational aspects to the phenomenon of the integration of these children are scarce and do not specify the most influential educational tools and strategies. In this sense, a descriptive, quantitative and cross-sectional research study is presented. The aim of this study is to examine whether variables such as age and the use of applications and social networks determine the personal learning environments (PLE) of unaccompanied foreign minors. The sample of the present study was formed by 624 individuals (♂ = 92.1% (n = 575); ♀ = 7.9% (n = 49)) aged between 8 and 17 years old. The majority came from Morocco and resided in the cities of Ceuta and Melilla. The “PLE and Social Integration of UFMs” questionnaire was used as the study instrument. Amongst the main findings, significant differences are highlighted in the personal learning environments as a function of age-related psychosocial factors as they pertain to unaccompanied foreign minors. Four factors were seen to exist in relation to the personal learning environments of unaccompanied foreign minors: self-concept of the learning process, planning and management of learning, use of resources and tools, and communication and social interaction. The same trend was observed in the four factors, with older age groups reporting better scores. On the other hand, results show that the use of applications and social networks have a significant and favourable impact on personal learning environment construction.

scholarly journals Metabolic characterization of menopause: cross-sectional and longitudinal evidence

2017 ◽  
Author(s):  
Qin Wang ◽  
Diana L Santos Ferreira ◽  
Scott M Nelson ◽  
Naveed Sattar ◽  
Mika Ala-Korpela ◽  
...  
Keyword(s):  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Metabolic Changes ◽  
Reproductive Status ◽  
Cross Sectional ◽  
Chronological Aging ◽  
Reactive Protein ◽  
Age Related ◽  
Post Menopausal ◽  
Metabolic Biomarkers

AbstractBackgroundIt remains elusive whether the changes in cardiometabolic biomarkers during the menopausal transition are due to ovarian aging or chronological aging. Well-conducted longitudinal studies are required to determine this. The aim of this study was to explore the cross-sectional and longitudinal associations of reproductive status defined according to the 2012 Stages of Reproductive Aging Workshop criteria with 74 metabolic biomarkers, and establish whether any associations are independent of age related changes.MethodsWe determined cross-sectional associations of reproductive status with metabolic profiling in 3,312 UK midlife women. In a subgroup of 1,492 women who had repeat assessments after 2.5 years, we assessed how change in reproductive status was associated with the changes in metabolic biomarkers. Metabolic profiles were measured by high-throughput quantitative serum NMR metabolomics. In longitudinal analyses, we compared the change in metabolic biomarkers for each reproductive status category change to that in the reference of being pre-menopausal at both time points. As all women aged by a similar amount during follow-up, these analyses contribute to distinguish age related changes from those related to change in reproductive status.ResultsConsistent cross-sectional and longitudinal associations of menopause with a wide range of metabolic biomarkers were observed, suggesting transition to menopause induces multiple metabolic changes independent of chronological aging. The metabolic changes included increased concentrations of very small VLDL, IDL and LDL subclasses, remnant and LDL cholesterol, and reduced LDL particle size, all towards an atherogenic lipoprotein profile. Increased inflammation was suggested via an inflammatory biomarker, glycoprotein acetyls, but not via C-reactive protein. Also, levels of glutamine and albumin were increased during the transition. Most of these metabolic changes seen at the time of becoming post-menopausal remained or became slightly stronger during the post-menopausal years.ConclusionsTransition to post-menopause has effects on multiple circulating metabolic biomarkers, over and above the underlying age trajectory. The adverse changes in multiple apolipoprotein-B containing lipoprotein subclasses and increased inflammation may underlie women’s increased cardiometabolic risk in post-menopausal years.AbbreviationsALSPACAvon Longitudinal Study of Parents and ChildrenBMIbody mass indexCRPhigh sensitive C-reactive proteinCVDcardiovascular diseasesHDLhigh-density lipoproteinHRThormone replacement therapyIDLintermediate-density lipoproteinLDLlow-density lipoproteinSDstandard deviationSTRAWStages of Reproductive Aging WorkshopSWANThe Study of Women’s health Across the NationVLDLvery low-density lipoprotein

scholarly journals 727. Predictors of Depressive Symptoms in Pregnant Partners in Seroconcordant Couples Living with HIV in Zambézia Province, Mozambique

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S462-S463
Author(s):  
Daniel Sack ◽  
Ariano Matino ◽  
Graves Erin ◽  
Almiro Emilio ◽  
Bryan Shepherd ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Male Partner ◽  
Hiv Treatment ◽  
Sub Saharan Africa ◽  
Hiv Care ◽  
Relationship Status ◽  
People Living With Hiv ◽  
Cross Sectional ◽  
Living With Hiv ◽  
Seroconcordant Couples

Abstract Background Depression contributes to HIV treatment outcomes in sub-Saharan Africa, where approximately 15% of people living with HIV have comorbid depression. HoPS+, a cluster randomized trial among seroconcordant couples living with HIV, assesses male partner involvement during antenatal HIV care and HIV outcomes. We describe predictors of depressive symptoms among pregnant partners living with HIV in Zambézia Province, Mozambique. Methods This baseline cross-sectional analysis includes 1079 female HoPS+ participants. We show demographic (age, enrollment date, relationship status, education, and occupation) and clinical (WHO HIV stage, body mass index [BMI], and antiretroviral therapy [ART] use history) factors. We model females’ depressive symptoms (Patient Health Questionnaire-9 [PHQ-9]) using proportional odds models with continuous covariates as restricted cubic splines (enrollment date, age, BMI, partner’s PHQ-9 score), categorical covariates (district, relationship status, education, occupation, WHO stage), and ART use history. Missing covariates were imputed 20 times. Results Participants’ median age was 23 (interquartile range [IQR] 20-28). Most women reported no or < 7 years of education (84.1%), were farmers (61.3%), and were WHO stage I (81.9%). They had a median PHQ-9 score of 3 (IQR 0-5) and 47 (43.6%) had moderately severe or severe depressive symptoms, with 19.6% missing PHQ-9 scores. Among 867 pregnant partners with PHQ-9s, demographic and clinical covariates were not meaningful predictors of PHQ-9 score. Male partner’s PHQ-9 score, however, was associated with (covariate-adjusted Spearman’s rho 0.58, 95% Confidence Interval [CI]: 0.51-0.65) and strongly predictive of a pregnant partner’s score (Figure). An increase in a male partner’s PHQ-9 score from 9 to 10 was associated with 1.47 times increased odds (95% CI: 1.37-1.58) of a ≥1-point increase in a woman’s PHQ-9 score Figure: Female Partner's Depressive Symptoms Conclusion Depressive symptoms are highly correlated among pregnant people and their partners, which may have implications for pregnancy care. Interventions aimed to reduce depressive symptoms and improve HIV-related outcomes during pregnancy may have greater success when focused on addressing both partners’ depressive symptoms. Disclosures All Authors: No reported disclosures

scholarly journals Depressive Symptoms Differentially Predict Neurocognition in Latinx and Non-Hispanic White People Living with HIV

2020 ◽  
pp. 1-12
Author(s):  
Emily P. Morris ◽  
Desiree Byrd ◽  
Angela C. Summers ◽  
Kayla Tureson ◽  
Vanessa Guzman ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Processing Speed ◽  
Cross Sectional Study ◽  
People Living With Hiv ◽  
Neurocognitive Performance ◽  
Cross Sectional ◽  
Neurocognitive Dysfunction ◽  
Affective Symptoms ◽  
Living With Hiv ◽  
Hispanic White

Abstract Objectives: Depression is common in people living with HIV (PLWH) and can contribute to neurocognitive dysfunction. Depressive symptoms in PLWH are often measured by assessing only cognitive/affective symptoms. Latinx adults, however, often express depressive symptoms in a somatic/functional manner, which is not typically captured in assessments of depression among PLWH. Given the disproportionate burden of HIV that Latinx adults face, examining whether variations in expressed depressive symptoms differentially predict neurocognitive outcomes between Latinx and non-Hispanic white PLWH is essential. Methods: This cross-sectional study included 140 PLWH (71% Latinx; 72% male; mean (M) age = 47.1 ± 8.5 years; M education = 12.6 ± 2.9 years) who completed a comprehensive neurocognitive battery, Wechsler Test of Adult Reading (WTAR), and Beck Depression Inventory-II (BDI-II). Neurocognitive performance was measured using demographically adjusted T-scores. BDI-II domain scores were computed for the Fast-Screen (cognitive/affective items) score (BDI-FS) and non-FS score (BDI-NFS; somatic/functional items). Results: Linear regressions revealed that the BDI-NFS significantly predicted global neurocognitive function and processing speed in the Latinx group (p < .05), such that higher physical/functional symptoms predicted worse performance. In the non-Hispanic white group, the cognitive/affective symptoms significantly predicted processing speed (p = .02), with more symptoms predicting better performance. Interaction terms of ethnicity and each BDI sub-score indicated that Latinx participants with higher cognitive/affective symptoms performed worse on executive functioning. Conclusions: Depressive symptoms differentially predict neurocognitive performance in Latinx and non-Hispanic white PLWH. These differences should be considered when conducting research and intervention among the increasingly culturally and ethnically diverse population of PLWH.

scholarly journals White matter changes and late-life depressive symptoms

2007 ◽  
Vol 191 (3) ◽  
pp. 212-217 ◽  
Author(s):  
Andrew Teodorczuk ◽  
John T. O'Brien ◽  
Michael J. Firbank ◽  
Leonardo Pantoni ◽  
Anna Poggesi ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Depressive Symptoms ◽  
White Matter ◽  
Later Life ◽  
Temporal Association ◽  
Cross Sectional ◽  
White Matter Changes ◽  
Treatment And Prevention ◽  
Age Related

BackgroundEvidence from cross-sectional studies suggests a link between cerebral age-related white matter changes and depressive symptoms in older people, although the temporal association remains unclear.AimsTo investigate age-related white matter changes on magnetic resonance imaging (MRI) as an independent predictor of depressive symptoms at 1 year after controlling for known confounders.MethodIn a pan-European multicentre study of 639 older adults without significant disability, MRI white matter changes and demographic and clinical variables, including cognitive scores, quality of life, disability and depressive symptoms, were assessed at baseline. Clinical assessments were repeated at 1 year.ResultsUsing logistic regression analysis, severity of white matter changes was shown to independently and significantly predict depressive symptoms at 1 year after controlling for baseline depressive symptoms, quality of life and worsening disability (P<0.01).ConclusionsWhite matter changes pre-date and are associated with the development of depressive symptoms. This has implications for treatment and prevention of depression in later life.

scholarly journals 2313

2017 ◽  
Vol 1 (S1) ◽  
pp. 73-73
Author(s):  
Nikhil Satchidanand ◽  
Jeffrey Fine ◽  
Gregory S. Cherr
Keyword(s):  
Mental Health ◽  
Depressive Symptoms ◽  
Health Status ◽  
Physical Function ◽  
Psychosocial Factors ◽  
Health Survey ◽  
Well Being ◽  
Mental Health Status ◽  
Community Dwelling ◽  
Physical And Mental Health

OBJECTIVES/SPECIFIC AIMS: To explore associations among bio-psychosocial factors predictive of overall physical and mental health status as assessed using the SF-12 Health Survey. METHODS/STUDY POPULATION: Community-dwelling, male and female elders with peripheral arterial disease (PAD) were administered an assessment battery to identify factors associated with self-assessed physical and mental health status using the SF-12 Health Survey. The battery included an assessment of pain, depressive symptoms, perceived social support, perceived psychological stress, physical function, as well as selected demographic variables. RESULTS/ANTICIPATED RESULTS: Preliminary linear regression analyses have identified several factors predictive of physical and mental health status including depressive symptoms, pain, perceived stress, and physical function. A more in-depth examination using path analysis is anticipated to reveal important mediational associations, wherein physical function is a strong mediator between bio-psychosocial factors and overall physical and mental health status. DISCUSSION/SIGNIFICANCE OF IMPACT: Aging is often associated with a reduction in physical and mental well-being, frequently exacerbated by the development and progression of chronic disease. PAD is a common chronic condition that places significant burden on the older patient and their family. Identifying and developing a more in-depth understanding of the factors that impact health status in PAD is an important and timely objective. We anticipate that our findings will inform development of more targeted and effective intervention strategies we can employ to improve the quality of life among elders struggling to manage PAD.

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