Mechanisms of Cognitive Aging in the HIV-Positive Adult

Purpose of Review As of the year 2016, an estimated 50% of the US HIV-positive population is aged 50 years or older. Due to a combination of increased rates of infection in older adults, and successful anti-retroviral (ART) regimens allowing HIV-positive adults to survive for decades with the disease, we are now faced with a steadily graying HIV-positive population, with only limited knowledge of how the cognitive and physiological effects of aging intersect with those of chronic HIV infection. Recent Findings Age-related changes to mood, cognition, and neurological health may be experienced differently in those living with HIV, and research concerning quality of life, mental health, and cognitive aging needs to account for and explore these factors more carefully in the coming years. Summary This review will explore the topic of cognitive aging with HIV: (1) central nervous system (CNS) infection of HIV and how the virus affects brain integrity and function; (2) cognitive and behavioral symptoms of HIV-associated neurocognitive disorders (HAND); (3) neurobiological theories of cognitive aging and how these processes may be exacerbated by HIV infection; and (4) clinical implications and complications of aging with HIV and factors that may result in poorer cognitive outcomes.