Healing hearts and mending minds (FitBrain): a home-based aerobic exercise intervention to improve cognitive outcomes in older persons living with HIV

Advances in antiviral treatment for HIV have led to greater longevity but there is continued risk for developing cardiovascular disease and cognitive impairment, particularly among older persons with HIV (PWH). The benefits of aerobic exercise for reducing cardiovascular disease are well established and have been shown to improve cognitive function in older adults but has had limited testing in older PWH and are inconclusive. This study aimed to test the efficacy of a home-based moderate intensity aerobic exercise intervention (Let's Move) to an attention control stretching and flexibility group (Let's Flex) over a one-year period among PWH with mild cognitive impairment and a minimum of 2 cardiovascular disease risk factors. Clinically stable (N = 115), asymptomatic older PWH (55 ± 5.2 years) were enrolled using 2:1 randomization to a Let's Move (N = 76) or Let's Flex (N = 39) group. Participants were predominately male (N = 66, 57.4%), African American (N = 100, 87%), and low cardiorespiratory fitness (mean V02 max 20.60 ± 5.33). There were no significant changes between or within groups in the primary outcome cognitive function. Retention rates were excellent > 90%, and high participant satisfaction. With the number of aging PWH anticipated to grow exponentially over the next several decades, it is essential that intervention strategies be developed to mitigate cognitive decline.