Effects of aerobic exercise on quality of life of people with HIV-associated neurocognitive disorder on antiretroviral therapy: a randomised controlled trial

Fostering healthy cognitive ageing in people living with HIV

Prevalence and incidence of HIV among people aged 50 years and older continue to rise worldwide, generating increasing awareness among care providers, scientists, and the HIV community about the importance of brain health in older adults with HIV. Many age-related factors that adversely affect brain health can occur earlier and more often among people with HIV, including epigenetic ageing, chronic medical conditions (eg, cardiovascular disease), and age-related syndromes (eg, frailty). Extensive dialogue between HIV community leaders, health-care providers, and scientists has led to the development of a multidimensional response strategy to protect and enhance brain health in people ageing with HIV that spans across public health, clinical spaces, and research spaces. This response strategy was informed by integrated ageing care frameworks and is centred on prevention, early detection, and management of brain health issues associated with HIV (eg, neurocognitive disorders), with specific considerations for low-resource or middle-resource countries. A collaborative, international, and data-informed update of the diagnostic criteria for HIV-associated neurocognitive disorders is a cornerstone of the proposed response strategy. The proposed response strategy includes a dynamic, international, online knowledge hub that will provide a crucial community resource for emerging evidence on the brain health of people ageing with HIV.

Changes of Serum C-Reactive Protein Level in Patients With Depressive Disorders After Treatment With Agomelatine Combined With Aerobic Exercise and Its Significance

OBJECTIVE

Depressive disorders constitute a series of debilitating diseases. This study investigated the therapeutic effect of agomelatine (AG) combined with aerobic exercise (AE) on patients with moderate-severe depression (MSD) and the changes of the serum C-reactive protein (CRP) level in patients after treatment as well as its significance.

METHODS

A total of 178 MSD patients were randomly assigned to the AG group (N = 90) and AG + AE group (N = 88). The severity of depressive disorders and anhedonia was assessed using the Hamilton Rating Scale for Depression (HAM-D), Beck Depression Inventory, and Snaith-Hamilton Pleasure Scale scores. The serum CRP level in MSD patients was detected by turbidity assay. Patients were defined as remitters, responders, and nonresponders according to the HAM-D 17 score, and the treatment efficacy was analyzed, followed by evaluation of the serum CRP level in patients with different treatment responses. Finally, the adverse reactions of patients during treatment were statistically analyzed.

RESULTS

After treatment, the HAM-D, Beck Depression Inventory, and Snaith-Hamilton Pleasure Scale scores and the serum CRP level of the 2 groups were reduced, and changes in the AG + AE group was more significant than that in the AG group. The clinical efficacy of the AG + AE group was better than that of the AG group. After treatment, the serum levels of CRP in remitters and responders were reduced, but not significantly in nonresponders. The incidence of adverse events in the AG + AE group was lower than that in the AG group.

CONCLUSION

AG + AE reduced the serum level of CRP in MSD patients and had good therapeutic effects on MSD patients.

Cognitive screening considerations for psychosocial clinical trials in HIV, aging, and cognition

Cognitive impairment is a common comorbidity among individuals aging with HIV, which can be an extreme source of stress and anxiety for many. Psychosocial interventions have the potential to alleviate symptoms associated with cognitive impairment and help improve the quality of life of people with HIV as they continue to age; these interventions are in the infancy of development and require further testing via clinical trials. The slow development of interventions may be partially attributed to a common trend of requiring a formal HIV-associated neurocognitive disorder diagnosis to qualify for psychosocial clinical trials. HIV-associated neurocognitive disorder is diagnosed through intensive, time-consuming tests, and still many cases of HIV-associated neurocognitive disorder remain undiagnosed, misdiagnosed, or misclassified due to the limitations of the assessment process. This commentary suggests an alternate method of screening for cognitive impairments through the use of a brief, low-barrier assessment, alongside validity considerations. Such alternate screening may improve enrollment and completion rates in psychosocial clinical trials for people aging with HIV and cognitive impairment, by removing the burden of extensive testing that is commonly associated with an HIV-associated neurocognitive disorder diagnosis from clinical trial eligibility, while still providing valuable insight into individuals' cognitive functioning.

Pickleball and mental health in adults: A systematic review

Introduction

Physical activity has been extensively studied and numerous mental health benefits have been found. Pickleball is an emerging racquet sport, which is characterized by its accessibility to all audiences and has become especially popular in the United States among the elderly. It is a novel team game and its inclusive nature is innovative for health improvement. The purpose of this systematic review was to review and evaluate existing studies that have examined the effects of pickleball on the mental and psychological health of individuals.

Methods

A systematic review was conducted on articles found in Scopus, PubMed, Elsevier, Web of Science (WoS), PsyINFO, Dialnet, and Elton B. Stephens Company (EBESCO) from 1975 to the present. The keywords used was a five combination between "Pickleball" joint with different terms by the connector AND, the second part of the combo could be "mental disorder" OR "anxiety" OR "depression" OR "psychological health" OR "mental health." Eligibility criteria included: papers focused on pickleball, in English or Spanish, on mental health variables, without establishing an age range. We excluded duplicate works, without access or that did not address the objective of this study.

Results

The search resulted in 63 papers, of which 13 were selected. A total of 90.74% of the population were people over 50 years of age. The results show significant improvements in the different psychological variables measured in pickleball practitioners: personal wellbeing, life satisfaction, depression, stress, happiness, etc., pickleball shows potential as a new tool to work and improve people's mental health.

Conclusions

The pickleball is displayed as an inclusive sport that does not need adaptations, resulting of great interest to be worked in different populations with mental problems.