An Applicable Framework for Understanding Successful Aging of People Living with HIV and Comorbid Chronic Obstructive Pulmonary Disease

Abstract

Chronic obstructive pulmonary disease (COPD) is a fatal chronic disease experienced by 10% of people living with HIV (PLWH). As the population of older PLWH continues to increase, the prevalence of COPD is anticipated to grow as well. Despite this concerning trend, there is a lack of theoretical models to guide clinical practice and research on aging with HIV and COPD. To address this gap, this article describes the Baltes and Baltes’ SOC (Selective Optimization with Compensation) Model as a guiding framework for understanding successful aging of PLWH with COPD. The article highlights eight areas of aging (eg, length of life, biological health, mental health, cognitive efficiency, social competence, productivity, personal control, and life satisfaction) with HIV and with COPD and the potential synergetic effects of having two critical chronic diseases. Drawing from a synthesis of literature, we adapted the SOC model to include dedicated areas specifically tailored for HIV, COPD, and the intersectional areas impacted by both conditions. Furthermore, we integrated bidirectional relationships within the eight areas of aging into the model, aiming to enhance the practical application of the modified model. Based on the identified gaps in the literature, implications for clinical practice, research, and future theoretical developments are provided.

Keywords:

• COPD
• HIV
• cognitive efficiency
• length of life
• successful aging

Author Contributions

All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.

Disclosure

Dr Anand Iyer reports grants from NIH, during the conduct of the study; grants from NIH, personal fees from AstraZeneca, outside the submitted work. Dr David Batey reports grants from the National Institute on Allergy and Infectious Diseases, grants from the National Institute on Mental Health, grants from the National Institute on Nursing Research, grants from the National Institute on Alcohol Abuse and Alcoholism, independent contractor for Birmingham AIDS Outreach, independent contractor for Association of Nurses in AIDS Care, outside the submitted work. The authors report no other conflicts of interest in this work.

Additional information

Funding

This article was supported by: an NIH/NINR R21-award (1R21NR016632-01; ClinicalTrials.gov [NCT03122288]; PI: Vance) titled “Individualized-Targeted Cognitive Training in Older Adults with HAND“; an NIH/NIMH R01-award (1R01MH106366-01A1; ClinicalTrials.gov [NCT02758093]; PI: Vance) titled “An RCT of Speed of Processing Training in Middle-aged and Older Adults with HIV“; an NIH/NIA R00-award (AG048762; PI: Fazeli) titled “A Novel Neurorehabilitation Approach for Cognitive Aging with HIV”; and an NIA/NIH K76 (AG064327; PI: Iyer) titled “Aging Well with COPD through Geriatrics-Palliative Care”.