Highly active antiretroviral therapy has given the chance to those living with HIV to keep on living, allowing them the opportunity to age and perhaps age successfully. Yet, there are severe challenges to successful aging with HIV, one of which is cognitive deficits. Nearly half of those with HIV experience cognitive deficits that can interfere with everyday functioning, medical decision making, and quality of life. Given that cognitive deficits develop with more frequency and intensity with increasing age, concerns mount that as people age with HIV, they may experience more severe cognitive deficits. These concerns become especially germane given that by 2015, 50% of those with HIV will be 50 and older, and this older cohort of adults is expected to grow. As such, this paper focuses on the etiologies of such cognitive deficits within the context of cognitive reserve and neuroplasticity. From this, evidence-based and hypothetical prevention (i.e., cognitive prescriptions), rehabilitation (i.e., speed of processing training), and mitigation (i.e., spaced retrieval method) strategies are reviewed. Implications for nursing practice and research are posited. 1. Introduction Highly active antiretroviral therapy (HAART) helps treat and prevent the spread of HIV [1–4] but also provides the opportunity for people to age with this disease [5]. This is welcome news to the 33 million people worldwide who are living with this disease [6]. Still, this population represents an enormous strain on the healthcare system of many countries grappling with this disease. For example, in South Africa approximately 17.8% of those between 18 and 49 are infected with HIV [6, 7], which means they must make difficult decisions in allocating resources and rationing healthcare [8–10]. All of this is occurring within the larger context of worldwide aging. The fastest growing age group on the planet is those 60 and older which constitutes 700 million people, and this cohort will swell to 2 billion by 2050 [11]. In part due to the unprecedented and historical event of global aging [12] along with HAART increasing the lifespan of those infected with HIV, the number of older adults with HIV is increasing ([5]; Figure 1). In the United States, it is projected that by 2015, half of those with HIV will be 50 and older [13, 14]. Although many are aging with this disease, later-life infections also occur. Those 50 and older account for 15% of all new diagnoses [15]. All of this ushers in new concerns such as how to promote quality of life and facilitate successful aging with HIV. Figure 1:
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