Improving Cognitive and Psychological Functioning in Older Latinos with HIV: Results from a Pilot Health Promotion Intervention.

Abstract

Background/objectives: Older Latino persons with HIV (OLPWH) experience early-onset cognitive decline due to specific factors associated with accelerated aging as well as more established risk factors like depression, anxiety, and sedentary behavior. Yet, few behavioral interventions to improve OLPWH's psychological and cognitive health have been assessed. Thus, this pilot study evaluated the feasibility, acceptability, and preliminary intervention effects of the Happy Older Latinos are Active (HOLA) physical activity health promotion intervention on cognition and mental health among this underserved population.

Research design/methods: Thirty OLPWH (Age: M=61.7 years, SD=6.00 years 40% female, 46.7% less than high-school education) enrolled in a pilot single-arm selective prevention intervention trial evaluating changes in psychological and neurocognitive outcomes at two timepoints (baseline and post intervention). Participants were asked at the end of the study to offer qualitative feedback on their acceptance of and interest in the intervention. Results: Within 7-months, enrollment targets were met (<5% of eligible participants refusing participation) and lost-to-follow up was minimal (10%). Participants attended an average of 54% of sessions and reported a high degree of satisfaction with the intervention via the Client-Satisfaction-Questionnaire-8 (M=30.5, SD=2.2). Significant improvements in cognitive (delayed recall [aRR=1.16], working memory [aRR=0.79], verbal fluency [aRR=1.09]) and psychological (depression [aRR=0.63], and anxiety severity [aRR=0.73]) domains were observed when controlling for age, gender, and education.

Discussion/implications: Results indicate that HOLA is an innovative and promising health promotion program that is uniquely tailored to address the multiple cognitive and psychological concerns affecting OLPWH in a non-stigmatizing and culturally acceptable manner.