The role of neuroplasticity and cognitive reserve in aging with HIV: recommendations for cognitive protection and rehabilitation

Abstract

By and large, the immune systems of people infected with HIV are being protected and maintained by advances in highly active antiretroviral therapy; as such, this is extending the lives of people into old age. Unfortunately, for many living with this disease, HIV is associated with neuroinflammation, co-morbidities, and accelerated aging which can compromise brain function, resulting in cognitive deficits. The purpose of this article is to highlight how to interpret these deficits within the framework of neuroplasticity and cognitive reserve for this clinical population. We suggest several recommendations for cognitive rehabilitation and mitigation such as addressing lifestyle factors, psychostimulants, cognitive remediation therapy, and treatment of depression and anxiety. Implications for nursing research and practice are posited.

Figures

Figure 1

The impact of HIV on the brain and HAART penetration of the blood brain barrier. Note. HAART = Highly Active Antiretroviral Therapy.

Figure 2

Causes of accelerated cognitive aging with HIV. Note. HAART = Highly Active Antiretroviral Therapy.