# Towards Objective Metrics to Quantify the Role of HIV and Increasing Cognitive Demand on Instrumental ADLs in People Aging with HIV

> **NIH NIH R21** · UNIVERSITY OF PENNSYLVANIA · 2022 · $191,406

## Abstract

PROJECT SUMMARY
About 37 million people are living with HIV (PLWH) worldwide. As they age and their HIV status becomes more
chronic, they face new challenges associated with the chronic management of HIV and experience a range of
physical, cognitive, and mental health-related issues that detrimentally impact their ability to perform instrumental
activities of daily living (IADLs) such as managing finances and medication management. Studies indicate that
80% of PLWH report experiencing at least one impairment, activity limitation, or social participation restriction
while others suggest 50%-70% have a “global” impairment in everyday functioning. While these impairments can
be partially attributed to traditional risks factors associated with aging, HIV itself preferentially impacts the
frontostriatal regions of the brain, leading to deficits in motor function, attention, information processing,
executive function, and memory. Most often these issues are overlooked in HIV and very little attempt is made
to rehabilitate them. Our long-term goal is to expand robot-based neurorehabilitation strategies to PLWH. The
objective of this proposal is to first objectively quantify the impact of aging with HIV on real-world IADLs. Since
IADLs often require both high levels of executive functioning during the performance of motor activities, we also
seek to apply a novel robot-based method to study how “IADL-like conditions” characterized by systematically
increasing cognitive demand in the executive function affect motor performance in adults aging with HIV as
oppose to their counterparts aging without HIV. In Aim 1, we will assess concurrent validity of a novel robot-
based motor and cognitive task with existing clinical tools used to predict motor impairment, cognitive
impairment and IADL function in older adults living with HIV. 42 participants aging with HIV and controls
with varying levels of IADL function will be evaluated using our robot-based task that simultaneously engages
motor and cognitive domains and standard clinical test battery. We hypothesize that our new robot-based task
will be an objective method that demonstrates concurrent validity with the clinical scales, especially those related
to gross and fine upper limb motor impairment, executive function and IADL function. In Aim 2, we will assess
interactions between increasing cognitive demand and motor performance in older adults living with HIV
and controls without HIV. 59 participants aging with HIV and controls will be evaluated using our novel robot-
based task while we will vary cognitive difficulty. We will measure changes in motor performance as a function
of increasing levels of task difficulty and HIV status. We hypothesize that the HIV group will demonstrate worse
motor performance as the task difficulty increases compared to controls. We will determine if this new task can
objectively probe how performance on complex IADLs may suffer with HIV status. This project supports the use
of...

## Key facts

- **NIH application ID:** 10468937
- **Project number:** 5R21AG073173-02
- **Recipient organization:** UNIVERSITY OF PENNSYLVANIA
- **Principal Investigator:** MICHELLE J. JOHNSON
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $191,406
- **Award type:** 5
- **Project period:** 2021-08-15 → 2025-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10468937

## Citation

> US National Institutes of Health, RePORTER application 10468937, Towards Objective Metrics to Quantify the Role of HIV and Increasing Cognitive Demand on Instrumental ADLs in People Aging with HIV (5R21AG073173-02). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10468937. Licensed CC0.

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