High-Intensity Exercise to Combat Vascular and Cognitive Dysfunction in Adults With HIV

University of Alabama at Birmingham60 enrolled

Overview

This is a single site, randomized exercise trial with individuals at least 50 years of age living with HIV who experience suboptimal cognition. The overall goals of this proposal are to determine whether 12 weeks of structured high-intensity interval training (HIIT) can overcome vascular and cognitive impairments (Aim 1) to a greater extent than continuous moderate exercise. Additionally, investigator will seek to identify barriers to engagement in exercise and the participants' perceptions of the study and exercise interventions (Aim 2). This study will enroll 60 participants in Birmingham, Alabama. Vascular function will be measured using pulse wave velocity. Cognition will be assessed using the full neuropsychological battery. Additionally, perceptions of exercise and the study as well as barriers to engaging in exercise will be determined through the analysis qualitative interviews. The overall hypothesis is that HIIT will result in greater enhancements in vascular and cognitive function. The investigators expect that individuals randomized to HIIT will result in greater satisfaction with the protocol. Based on the data collected, the investigators seek to develop tailored intervention to promote successful aging among older people living with HIV.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

OTHER

Masking

Interventions

High-Intensity Interval TrainingBEHAVIORAL

Following a 5-minute warm-up at 50% VO2peak, high and moderate-intensity exercise bouts alternate, progressing to five bouts of 4-minute high-intensity exercise (90% VO2peak), alternating with four 3-minute bouts of moderate-intensity exercise (50% VO2peak) by week 8, followed by a 5 minute cool-down. The total exercise time is 42 minutes.

Continuous Moderate ExerciseBEHAVIORAL

Following a 4 minute warm-up at 50% VO2peak, the participant walks for up to 42 continuous minutes at 60% VO2peak, followed by a 4 minute cool-down. The total exercise time is 50 minutes.

Eligibility

Sex: ALLMin age: 50 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Age 50 years and older * Sedentary lifestyle, deﬁned as \< 150 min/wk moderate physical activity as assessed by CHAMPS questionnaire * Neurocognitive Impairment (as assessed using the BRACE+ * Prescribed HIV ART for ≥ 12 months, with no current use of older drugs with established mitochondrial toxicity * Able to speak, read, and write in English * Willingness to participate in all study procedures Exclusion Criteria: * Diagnosis of mitochondrial disease * Active substance abuse or factors preventing compliance or safety * Uncontrolled hypertension, deﬁned as resting BP \> 150/90 mmHG * Chronic kidney disease * Severe cardiac disease, including NYHA Class III or IV congestive heart failure, clinically signiﬁcant aortic stenosis, history of cardiac arrest, use of a cardiac deﬁbrillator, or uncontrolled angina * Acute myocardial infarction identiﬁed by medical history and ECG * Pulmonary disease requiring the use of supplemental oxygen * Poorly controlled diabetes * Neuropsychologically Intact * Orthopedic problems that limit ability to perform exercise * Simultaneous participation in another intervention trial

Outcomes

Primary Outcomes

Change in vascular function

Arterial stiffness is a continuous measure of cardiovascular disease risk.

Time frame: Baseline, Up to 16 weeks, 3-months Post-Intervention

Change in cognitive function

Cognitive function will be measured using BRACE+, a neuropsychological battery

Time frame: Baseline, Up to 16 weeks, 3-months Post-Intervention

Secondary Outcomes

Barriers to Engagement in Exercise

This will be assessed during qualitative interviews grounded in the Theoretical Domains Framework.

Time frame: Baseline

Perceptions of the Study and Exercise Interventions

This will be assessed during qualitative interviews grounded in the Theoretical Domains Framework.

Time frame: Up to 16 weeks