Alzheimer's Disease Phenotypes in Older HIV+ Adults: A Multimodal Imaging Study
January 11, 2017
Despite significant advances in medical treatment, approximately half of patients with HIV-infection are affected by reduced brain functions. Age is proposed to be one of the main factors. Previous studies have found that older HIV+ adults are at higher risk for impairments to brain functions than their younger counterparts and age-matched HIV-negative controls. With more than half of individuals living with HIV in the USA are now 50 years old or older, there is an increasing demand for HAND diagnosis and treatment. However, this aging demographic also means an increasing fraction of the HIV+ populace advancing into the geriatric age range, and clinicians are now facing the challenge of differentiating HAND from other dementias of aging, including Alzheimer's disease, the most common cause of dementia in HIV-uninfected older adults. With the rapidly-aging HIV+ population, addressing this issue – the identification of AD in older HIV+ adults – is of increasing public health relevance. The diagnosis of HIV brain disease plus or minus AD leads to different treatments and different clinical outcomes. The proposed pilot study will develop and validate an MRI-based biomarker that has the potential to differentiate cognitive impairment due to AD vs. HAND pathology, or both, in older (>65 years old) HIV-infected adults.