The purpose of this study is to determine the efficacy of Mindfulness Based Stress Reduction (MBSR) to alleviate stress, anxiety, and depressive symptoms, and improve attention among patients aged 60 or older who suffer from HIV-associated neurocognitive disorders (HAND) and have maximized treatment options.
This study addresses symptom management for patients aged 60 and older who are living with HIV infection, are on combination antiretroviral therapy (cART) with suppressed viral loads, and yet continue to experience behavioral and cognitive symptoms of HIV-associated neurocognitive disorders (HAND). It is increasingly relevant that HAND persists despite cART, impacting between 30-50% of elders living with HIV. Patients suffer symptoms that are pervasive in their impact on everyday functioning and quality of life; yet these patients are currently left with a dearth of treatment options. In this study, the investigators employ a randomized controlled evaluation of Mindfulness Based Stress Reduction (MBSR) to target attention, stress, anxiety, and depressive symptoms among patients who have HAND and have maximized treatment options. The investigators will employ intrinsic connectivity network (ICN) analyses of resting state functional magnetic resonance imaging to demonstrate increased strength of brain networks corresponding to improved symptoms. The investigators will quantify social networks and perceived strength of social networks to determine if they moderate the main findings. Together this work employs geriatric, neuroscience and complementary medicine disciplines to reduce the symptom burden in aging HIV-infected patients.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
180
Mindfulness Based Stress Reduction (MBSR) is a standardized 8 week course taught by trained instructors.
UCSF Memory and Aging Center
San Francisco, California, United States
Continuous Performance Task
A neuropsychological test to assess attention and information processing and executive functioning
Time frame: 48 weeks after enrollment
Symbol-Digit modalities test
A neuropsychological test to assess executive functioning
Time frame: 48 weeks after enrollment
Letter Number Sequencing
A neuropsychological test to assess executive functioning
Time frame: 48 weeks after enrollment
Activities of Daily Living (ADL) & Instrumental Activities of Daily Living (IADL) scales
Questionnaires to assess everyday function
Time frame: 48 weeks after enrollment
Perceived Stress Scale
Questionnaire to assess stress
Time frame: 48 weeks after enrollment
State-Trait Anxiety Inventory
Questionnaire to assess anxiety
Time frame: 48 weeks after enrollment
Geriatric Depression Scale
Questionnaire to assess depression
Time frame: 48 weeks after enrollment
Buss-Durkee Irritability subscale
Questionnaire to assess irritability
Time frame: 48 weeks after enrollment
Center for Neurological Study - Lability Scale
Questionnaire to assess affective lability
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Time frame: 48 weeks after enrollment
Affective Intensity Measure
Questionnaire to assess euphoria
Time frame: 48 weeks after enrollment
World Health Organization Quality of Life - HIV Scale
Questionnaire to assess quality of life
Time frame: 48 weeks after enrollment
Connectivity of the default mode network (DMN) as determined by analysis of resting state functional magnetic resonance imaging
Time frame: 16 weeks after enrollment
Connectivity of the salience network (SAL) as determined by analysis of resting state functional magnetic resonance imaging
Time frame: 16 weeks after enrollment