In addition to the obvious health problems and/or physical limitations associated with HIV, diabetes, and aging, each of these are known to independently affect cognitive functioning. While this relationship to cognition does not necessarily mean frank cognitive impairments are inevitable with HIV, diabetes, and aging, it does entail that each of these conditions may lead to poorer cognitive performance compared to younger adults and individuals without HIV and diabetes. Many individuals may be aware of the physical symptoms associated with these diseases, but may be unaware of the cognitive outcomes associated with HIV and diabetes, especially if not controlled by medication and a healthy lifestyle. Additionally, individuals may be unaware of the significance of maintaining optimal cognitive functioning in order to maintain optimal everyday functioning abilities such as driving, cooking, managing medication regimens, and negotiating finances. Given that highly active antiretroviral therapy (HAART) has allowed individuals with HIV to live to reach older adulthood, and that dysglycemia and/or type 2 diabetes can be a metabolic side effect of these medications (; ; ), it is reasonable to assume that there is a subset of individuals aging with HIV and diabetes, which may become more prevalent as individuals continue to age with HIV in the coming decades. Thus, the purpose of this article is to inform healthcare providers and researchers about the cognitive outcomes associated with HIV, diabetes, and aging independently within the context of cognitive reserve, and then to examine the potential synergistic effects of these conditions in individuals living with all three (). This article also incorporates potential intervention strategies to protect and possibly improve cognitive functioning, or at the very least mitigate cognitive loss, in this population.The synergistic effects of HIV, type 2 diabetes, and aging on cognition and cognitive reserve.
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