Trajectories of Cognitive Aging among American Indian and Alaskan Native People with and without HIV

Micah Savin, Fordham University


This study described trajectories of cognitive aging among AI/AN adults with and without HIV and the role of biosociocultural factors longitudinally. To accomplish this, we characterized trajectories of cognitive aging in a sample of 333 American Indian/Alaska Native (AI/AN) and 309 non-Latinx White (NLW) adults who were followed longitudinally for up to 20 years by the HIV Neurobehavioral Research Program (HNRP) across six U.S. satellite sites. After assessing missingness and multiple imputation convergence, growth curve modeling with autoregressive lag-1 structures with heterogenous residual variances were used to assess the role of ethnoracial identity, HIV status, HIV clinical indices, education, and language upon decline in trajectories of cognitive aging. Age was used as our continuous metric of time. This study found that AI/AN adults demonstrated earlier and steeper decline in normative trajectories of cognitive aging on tasks of processing speed and timed tasks of attention/working memory, executive function, and psychomotor speed in comparison to NLW adults. Mechanisms of risk seemed both shared and unique across AIAN subpopulations, such as the greater risk for an amnestic profile among Latinx AI/AN populations. Accentuated trajectories of cognitive aging were evident in HIV in comparison to HIV- controls and are primarily driven by the role of immunosenescence. Disparate trajectories of cognitive aging in set-shifting abilities remained evident after adjusting for educational differences between AI/AN and NLW adults. Broadly, AI/AN adults did not benefit equally from the protective effects of greater years of education upon set-shifting abilities in early adulthood in comparison to their NLW peers. HIV status influenced the effects of education upon trajectories of cognitive aging, such that those with fewer years of education and weaker immune systems had steeper slopes in decline on set- shifting tasks. Regarding the effects of language, monolingual Spanish-speaking and bilingual English/Spanish-speaking groups had steeper slopes of decline as they aged in comparison to monolingual English-speaking groups. Language status significantly influenced the effects of HIV status upon performance on tests of executive function, such that Spanish-speakers poor performance was exacerbated in the context of immunosenescence. In conclusion, the interplay of biosociocultural factors explain significant variance in AI/AN disparities in trajectories of cognitive aging.

Subject Area

Clinical psychology|Neurosciences|Native American studies

Recommended Citation

Savin, Micah, "Trajectories of Cognitive Aging among American Indian and Alaskan Native People with and without HIV" (2023). ETD Collection for Fordham University. AAI29253226.