Accelerated aging?

As people with HIV live longer and longer they are experiencing what it means to age. Are they aging differently? What are the similarities to typical aging and what are the unique aspects that may have resulted from HIV? There are no clear answers to these issues. Research continues to probe and understand the interaction of HIV with aging. Still, the older adult often wonders if they are experiencing aging not only differently but earlier than others. Often the older adult with HIV attributes every ache, pain, lost memory and any illness to be a result of HIV. Perception is reality. Are those conditions (comorbidities) typically seen as part of the aging process occurring at accelerated rates or with higher frequency (accentuated) in HIV-infected adults?

At this juncture, conclusions should be tentative. Some believe, perceive, that accelerated aging is occurring due to HIV. The term “accelerated aging” refers to the theory that persons with HIV suffer a speeding up of the natural process of aging. This would result in the earlier onset of several diseases and conditions, such as heart disease, kidney failure, cancer, etc., There is anecdotal evidence and certain research reports that indicate this might be true. However, there are a multitude of studies that are not consistent with this interpretation

The challenge in addressing this issue is finding and using the ideal control group, people without HIV, for the best comparisons, and, to have information on the two groups over time. Most of the reported studies have used overall population statistics, or samples that are not well matched to the older persons with HIV for comparison. It is not just similar age and sex in the comparison group, but important variables, such as socioeconomic class, education, insurance, life experience, use of alcohol and addictive drugs and other important variables (risk factors) that can affect health status and outcomes. A landmark study of US Veterans, where both similar individuals with and without HIV receive the same medical care, has provided important information to address this issue. What was found suggests the major problems of heart disease, kidney failure and cancer occur at about the same time in the HIV group but with more frequency (multimorbidity) than in the comparison group. So, there was no “acceleration”, but rather “accentuation” of those conditions associated with aging. Of course, other well-designed studies will be necessary to confirm these results, but it appears the diseases are not occurring prematurely but in greater numbers.

What can you and your physician do to address this problem?

First, if you are not now taking ART for any reason, you should start therapy immediately to reduce the negative effects of the virus. The availability of single pill regimens will make adherence to the medication easier.

Second, the best preventive medicine for various chronic illnesses, including heart disease, cancer, and diabetes, needs to be implemented on a regular basis (see Reducing Risk).

Third, you should follow your medical regimens faithfully and comply with any orders for lab tests or other interventions.

 

What you can do

Maintaining a positive attitude is an essential assist in managing one’s health as one ages. Often our beliefs, be they right or wrong, can significantly affect our behaviors and emotions. Some may be fatalistic and not follow good health behaviors. Others will worry far beyond our typical concerns as we live each day one at a time.

In 2010 two significant HIV researchers observed that accelerated aging in the HIV older adult is an “intriguing” hypothesis, and, that we should not allow it to become ingrained in the culture of HIV before it has been supported. Most would agree that the perception that accelerated aging was occurring is common. But it remains to be proven.  

Whether the problem is accelerated or accentuated aging, right now the best approach is to do what you can to address the challenges presented by the risks for developing multimorbidity and keep a positive attitude about the future. Statistics on longevity are on your side.

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