SAN FRANCISCO — Some 45 years ago, the first cases of AIDS appeared in New York, and then, everywhere. Three years later, Human Immunodeficiency Virus (HIV) was identified as the cause, followed over the ensuing four decades by ever-improving treatments for HIV and its prevention. However, those managing their infection for decades, now face the risk of much higher rates of dementia (as much as nearly double) than those found in their HIV-negative peers. A new study found a brain exercise regimen used in conjunction with compensatory cognitive training helped improve the cognitive status of people with HIV, who face that risk. The brain exercises used in the study are found in app BrainHQ — the same app shown in studies over the past six months to rejuvenate brain chemical production in older adults, to improve brain wiring after brain injuries, and to reduce dementia risk in older adults for decades after use.
Rather ambitiously, the new study in people living with HIV set out to determine if cognitive interventions developed in the Global North could be effective in the Global South. The study was conducted in South Africa among people with HIV and provided instructions for the interventions translated into their native Xhosa language. This novel study showed such a strategy could be effective, and the number of people assessed as cognitively impaired was significantly reduced.
Of the 43 participants, 26 were randomized into an intervention group asked to individually engage in computerized BrainHQ exercises (for a total of 10 hours) and to participate in ten classes in compensatory strategies. The 17 participants (after four were dropped for non-attendance) in the control group, were asked to spend similar amounts of time on computerized casual games (such as Solitaire) and in goal-oriented group meetings led by a counsellor. Using the primary outcome measure of neurocognitive impairment (NCI), at the beginning of the study, 70.4 % of the intervention group were assessed as impaired, which dropped to 29.6 % after the intervention. In the control group, the percent with NCI actually increased from 50% to 56.4%.
“The really good news is people with HIV are aging,” notes Dr. David Vance, an HIV research expert at the University of Alabama at Birmingham School of Nursing and co-author of the study. “Of course, aging brings cognitive concerns and vulnerabilities. This study adds to strong evidence that cognitive training can improve cognitive abilities and reduce some of those concerns. Now, our challenge is raising awareness among people with HIV and their care providers and getting cognitive training into the hands of people who could benefit.”
Researchers from around the globe have produced 11 prior studies and review articles on the usefulness of BrainHQ interventions and assessments to people living with HIV. Such findings have included: significant improvements in processing speed, the correlation of higher processing speed to higher medical adherence, significant improvement in global cognition, significant improvement in performing daily activities, and significantly reduced stress.
“There’s an opportunity to not only address neurocognitive decline, but also to try to help defuse what some have called a ‘ticking time bomb’ of increased dementia risk, as people with HIV age into and advance as senior citizens,” observed Dr. Henry Mahncke, CEO of Posit Science, which makes the brain training app BrainHQ. “Providers and organizations who work in HIV have been key agents in making HIV a treatable chronic condition and are likely to want to move quickly in addressing dementia risk as a standard part of clinician-supervised care, as they have with other therapeutic lifestyle interventions, which may be implemented with medically necessary clinical oversight.”
“While this is not a large study, the results are significant and quite remarkable,” Dr. Mahncke added. “They also are consistent with what we’ve seen in more than 100 studies in older adults, pre-dementia populations, and in dementia prevention. It’s time to move from research to improved clinician-supervised care.”
BrainHQ exercises have shown benefits in more than 300 studies. Such benefits include gains in –cognition (attention, speed, memory, decision-making), in quality of life (depressive symptoms, confidence and control, health-related quality of life) and in real-world activities (health outcomes, balance, driving, workplace activities). BrainHQ is used by leading health and Medicare Advantage plans, by leading medical centers, clinics, and communities, and by elite athletes, the military, and other organizations focused on peak performance. Consumers can try a BrainHQ exercise for free daily at https://www.brainhq.com.