All ETDs from UAB

Advisory Committee Chair

Despina Stavrinos

Advisory Committee Members

Karlene K Ball

Sylvie Mrug

David E Vance

Pariya F Wheeler

Document Type

Dissertation

Date of Award

2017

Degree Name by School

Doctor of Philosophy (PhD) College of Arts and Sciences

Abstract

Human immunodeficiency virus (HIV) currently affects over 1 million individuals in the United States. It is estimated that by the year 2020, up to 70% of individuals with HIV in the United States will be ages 50 and older, as these individuals live longer due to more advanced medicine and later diagnosis. Aging research suggests individuals with HIV may be at risk for accelerated or accentuated aging making age-related deficits, particularly with cognition and everyday functioning, of public concern. The current study investigated the complex associations between age, HIV disease state, cognition, health, and driving in 139 older adults (Mage = 58.68, SD = 7.84), with HIV (n = 73) and without (n = 66) by using questionnaires, the NIH Toolbox – Cognition Battery, Useful Field of View®, and a driving simulator. Group differences, bivariate correlations, and path analyses were conducted to assess the role of age and HIV disease state on driving performance and the potential mediating effects of processing speed, executive function, and health. Findings revealed significant associations between age and HIV disease state on cognition and health variables, such that older adults performed worse on a processing speed measure and being HIV+ was associated with poorer perceived health, less cognitive reserve, and marginally with poorer performance on executive function measures. Furthermore when driving performance was assessed across the entire sample, older age was associated with slower speed (β = -0.279, p = 0.013), higher cognitive reserve was marginally associated with better lane maintenance abilities (β = -0.238, p = 0.063), and better processing speed was marginally associated with more self-reported negative driving outcomes (β = 0.180, p = 0.075). No significant associations emerged for HIV disease state and driving nor any significant indirect effects. While age and HIV disease state showed multiple associations with cognition and health, only age was related to driving outcomes. Strengths and limitations are discussed, but further investigation is warranted into the complex associations between age, HIV disease state, and driving behavior.

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