UCSF researchers studying cognition in older HIVers
by Seth Hemmelgarn
With many people who have HIV and AIDS living longer, thanks to advances in medications, a group of researchers and doctors at the University of California, San Francisco is looking at how having HIV might affect cognitive health in people over 60.
People who have HIV and are over 60 are being sought for the three-year study. Those interested should be stable on anti-retroviral therapy, not using illicit drugs, and should be free of hepatitis C, among other factors.
According to statistics on the San Francisco Department of Public Health's Web site, there were at least 1,059 people 60 and over living with AIDS in the city as of March 31. Data on people over 60 living with HIV was not available.
"We'd like to know if they're likely to have more problems with memory and thinking, and if they are, why?" said Dr. Victor Valcour, adjunct clinical instructor at the Memory and Aging Center at UCSF, where the research is being done.
Valcour said the current thinking is that HIV, possibly along with the medications used to treat it, may cause more insulin resistance, which occurs when the body begins to have difficulty metabolizing sugar. Insulin resistance is thought to be the precursor to diabetes.
Diabetes and other metabolic problems may lead to small changes in brain function that could mean a risk for mild and severe cognitive problems. Mild problems can mean things like trouble concentrating, while severe issues can include dementia. That's when day-to-day functioning is affected so strongly that a person may not be able to keep their job.
Valcour said researchers would examine factors involved in cognitive health and possibly put a different emphasis on treating some problems, such as diabetes, early. They'll also be looking at whether the problems are simply related to getting older, although they believe it's more than that.
He noted these problems are not unique to people living with HIV, but depending on the group being studied, from one-third to half of people can have mild symptoms of cognitive problems.
Valcour said dementia isn't seen as much as it used to be, and it's not clear what leads to the problem â€“ the medications, the HIV itself, or a combination of the two. He said people may also experience injuries, before beginning medications, which lead to dementia.
The study started in January, and Valcour said there are somewhere between five and 10 people participating. Researchers are looking for about 40 more.
Participants will be paid $150 in compensation the first year, after completing cognitive and neurological exams, as well as an oral glucose tolerance test and an MRI. The three visits will be done over the course of about a month.
In subsequent years, participants will be paid $50, for one visit. The cognitive and neurological exams will be performed again. MRIs are currently only planned for the first year.
Valcour estimated the study would cost $300,000 over three years. He did not have permission to disclose the major source of the funding.
For more information, call (415) 476-1451 or e-mail InsulinStudy@memory.ucsf.edu.