Predicting Trajectories of Everyday Functioning in Adults Aging with HIV Using Latent Growth Mixture Modeling

Area of Science:

• Gerontology
• Infectious Diseases
• Neuroscience

Background:

• Aging people with HIV (PWH) face significant adverse health outcomes, including declines in everyday functioning.
• Understanding the patterns and predictors of functional trajectories is crucial for PWH.
• HIV disease characteristics and comorbidities can impact long-term health and daily living.

Purpose of the Study:

• To identify distinct trajectories of self-reported everyday functioning in aging PWH.
• To examine baseline predictors, including demographics, cognitive function, comorbidities, and HIV disease characteristics, of these functioning trajectories.

Main Methods:

• Latent growth mixture modeling was used to analyze data from 742 PWH over two years.
• Participants completed up to five semi-annual visits assessing everyday functioning.
• Predictors included demographics, cognitive domains, psychiatric and medical comorbidities, and HIV disease characteristics.

Main Results:

• A 3-class linear solution identified distinct functioning trajectories: stable (88%), worsening (7%), and improving (5%).
• Depressive symptoms and impaired motor skills were associated with higher odds of impaired functioning.
• Chronic pulmonary disease predicted improved functioning, while older age predicted worsening functioning.

Conclusions:

• Most aging PWH exhibit stable everyday functioning.
• Targeted interventions for depression and motor skill impairments may enhance functioning in PWH.
• Healthcare engagement, potentially indicated by managing chronic pulmonary disease, may be linked to functional improvement.