~46 spots leftby Feb 2026

Executive Functioning Training for Cognitive Impairment in Aging Adults with HIV (EFT Trial)

Palo Alto (17 mi)
Age: 18+
Sex: Any
Travel: May be covered
Time Reimbursement: Varies
Trial Phase: Phase 2
Recruiting
Sponsor: University of Alabama at Birmingham
No Placebo Group
Prior Safety Data

Trial Summary

What is the purpose of this trial?This trial uses a computer program with brain exercises to help adults with HIV who have cognitive issues. The exercises aim to improve thinking skills by requiring participants to switch between tasks and make decisions. This could help reduce cognitive problems and improve daily functioning.
What safety data exists for Executive Functioning Training in aging adults with HIV?The research suggests that cognitive training, including Executive Functioning Training, is generally considered safe and has shown potential benefits in improving cognitive functions in adults with HIV. The studies reviewed indicate improvements in targeted cognitive domains, mood, and quality of life, with no significant safety concerns reported. However, more evidence is needed to establish comprehensive treatment guidelines.23456
Is Executive Functioning Training a promising treatment for cognitive impairment in aging adults with HIV?Yes, Executive Functioning Training is a promising treatment. Research shows that it can improve cognitive functions like memory and attention, which are often affected in adults with HIV. This training can enhance everyday activities, mood, and quality of life, and may even reverse cognitive impairments.23456
Do I need to stop my current medications for this trial?The trial protocol does not specify whether you need to stop taking your current medications.
What data supports the idea that Executive Functioning Training for Cognitive Impairment in Aging Adults with HIV is an effective treatment?The available research shows that Executive Functioning Training, a type of cognitive training, can improve cognitive functions in aging adults with HIV. One study found that participants who underwent cognitive training showed improvements in working memory, while those in the control group did not. Another study indicated that cognitive training could improve specific cognitive areas, potentially reversing the diagnosis of HIV-associated neurocognitive disorder (HAND). Additionally, a systematic review of 13 studies suggested that cognitive training enhances cognitive function, leading to better everyday functioning, mood, and quality of life. Compared to no treatment, cognitive training appears to offer significant benefits for those with cognitive impairments related to HIV.13456

Eligibility Criteria

This trial is for English-speaking adults over 40 with HIV-Associated Neurocognitive Disorder (HAND) who can meet in person and commit to a ~12-week program. It's not for those with major health issues like schizophrenia, significant brain trauma, or recent COVID-19 infection; those undergoing intense treatments like chemo; or individuals living far from the center or in unstable housing.

Treatment Details

The study tests if Executive Functioning Training over 20 hours improves cognitive abilities in aging adults with HAND compared to no training. Participants are split into two groups: one receives the training and the other doesn't, allowing researchers to see if there's an improvement in cognitive functioning.
2Treatment groups
Experimental Treatment
Active Control
Group I: Executive Functioning TrainingExperimental Treatment1 Intervention
BrainHQ (POSIT Science Inc.) computerized cognitive training modules will be used as in our other studies; but these will focus on executive functioning training. These programs have gaming components that encourage adherence. BrainHQ cognitive training products are tested and endorsed by the scientific community. A meta-analysis of computerized cognitive training in older adults found optimal therapeutic effects occurred when training sessions last at most 60 minutes and are administered 1-3 times per week - dosage parameters already incorporated in our study. This self-administered program uses touch-screen technology with tablets which allows computer novices to engage with the training exercises.
Group II: No-Contact Control GroupActive Control1 Intervention
These participants will not receive any intervention.

Find a clinic near you

Research locations nearbySelect from list below to view details:
UAB School of NursingBirmingham, AL
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Who is running the clinical trial?

University of Alabama at BirminghamLead Sponsor

References

Predictors of improvement following speed of processing training in middle-aged and older adults with HIV: a pilot study. [2023]Speed of processing training has been shown to improve cognitive functioning in normal older adults. A recent study demonstrated that middle-aged and older adults with HIV also improved on a measure of speed of processing and a measure of everyday functioning after such training. The primary objective was to examine what predicts the speed of processing training gains observed in the previous study. Participants were administered an extensive battery of demographic, psychosocial, and neuropsychological measures at baseline. They were randomized either to the speed of processing training group (n = 22) or to a no-contact control group (n = 24). Participants received approximately 10 hours of computerized speed of processing training. Predictors of training gains on the Useful Field of View (UFOV) Test and the Timed Instrumental Activities of Daily Living (TIADL) Test were examined through correlational analyses. In general, those who performed worse on the UFOV and TIADL at baseline demonstrated significantly more training gains. Also, higher HIV viral load, poorer medication adherence, a higher number of years diagnosed with HIV, and lower baseline scores on the Wisconsin Card Sorting Test (an executive functioning measure) were correlated with better TIADL training gains. TIADL performance improved in those with higher HIV viral load, poorer medication adherence, and poor executive functioning. Speed of processing training may be a way to improve everyday functioning and therefore quality of life in more medically and cognitively vulnerable adults with HIV.
Remediating HIV-Associated Neurocognitive Disorders via Cognitive Training: A Perspective on Neurocognitive Aging. [2017]Over 50% of adults with HIV exhibit some form of HIV-associated neurocognitive disorder, ranging from mild asymptomatic neurocognitive impairment to HIV-associated dementia. As adults age with HIV and become susceptible to cardiovascular and metabolic comorbidities, the prevalence and severity of such neurocognitive disorders are likely to increase. With compromised renal and hepatic functioning often accompanying HIV, pharmaceutical interventions to address such neurocognitive disorders may not be the best strategy and are not without risks. Fortunately, as noted in the geriatric literature, cognitive training strategies have been shown to improve targeted neurocognitive domains and everyday functioning. A review of some of these cognitive training strategies, especially as they relate to aging with HIV, are highlighted and explained in the context of neuroAIDS, aging, and neurocognitive reserve. Implications for practice and research are provided.
The Acceptability and Potential Utility of Cognitive Training to Improve Working Memory in Persons Living With HIV: A Preliminary Randomized Trial. [2018]HIV-associated neurocognitive impairments that impact daily function persist in the era of effective antiretroviral therapy. Cognitive training, a promising low-cost intervention, has been shown to improve neurocognitive functioning in some clinical populations. We tested the feasibility, acceptability, and preliminary effects of computerized cognitive training to improve working memory in persons living with HIV infection (PLWH) and working memory impairment. In this randomized clinical trial, we assigned 21 adult PLWH to either an experimental cognitive training intervention or an attention-matched control training intervention. Participants completed 12 training sessions across 10 weeks with assessments at baseline and post-training. Session attendance was excellent and participants rated the program positively. Participants in the experimental arm demonstrated improved working memory function over time; participants in the control arm showed no change. Our results suggest that cognitive training may be a promising intervention for working memory impairment in PLWH and should be evaluated further.
Can computerized cognitive training reverse the diagnosis of HIV-associated neurocognitive disorder? A research protocol. [2019]Nearly 50% of adults with HIV have some form of HIV-associated neurocognitive disorder (HAND), ranging from subtle to symptoms that interfere with everyday functioning and quality of life. HAND is diagnosed when a person performs more than 1 standard deviation below his or her normative mean on standardized measures in two or more cognitive domains (e.g., attention, speed of processing, verbal memory, executive functioning). As adults age with HIV, they are more likely to develop comorbidities such as cardiovascular disease, hypertension, and insulin resistance that may further contribute to poorer cognitive functioning and HAND. Certain computerized cognitive training programs may be able to improve specific cognitive domains in those with HIV. Such programs may be effective in changing the diagnosis of HAND in cognitively vulnerable adults. In this article, we describe the design and methods of TOPS-the Training On Purpose Study. In this on-going experimental study, 146 older adults (50+) with HAND are randomized to either: (i) an Individualized-Targeted Cognitive Training group, or (ii) a no-contact control group. This study targets those cognitive domains in which participants experience a deficit and trains participants with the corresponding computerized cognitive training program for that domain. An Individualized Targeted Cognitive Training approach using cognitive-domain-specific cognitive training programs may offer symptom relief to those individuals diagnosed with HAND, which may actually reverse this diagnosis. Given that these cognitive training programs are commercially available, this approach represents a potential paradigm shift in how HAND is considered and treated.
Computerized Cognitive Training for the Neurocognitive Complications of HIV Infection: A Systematic Review. [2019]The synergistic effects of HIV and aging on the brain may compromise cognitive reserve, resulting in HIV-associated neurocognitive disorder. The neuroscience literature suggests that computerized cognitive training programs represent a practical strategy to protect or remediate cognitive functioning in older adults. Such cognitive training programs may hold similar therapeutic benefits for adults living with HIV. This systematic review evaluated the effects of cognitive training interventions in adults living with HIV. This systematic review includes 13 studies that have been conducted or are being conducted. Results suggest that cognitive training may improve the cognitive domain that is the target of training. One case study even demonstrated a reversal of HIV-associated neurocognitive disorder after cognitive training. Although greater evidence is needed to establish treatment guidelines, current evidence suggests that cognitive training improves cognitive function, which translates to more optimal everyday functioning (i.e., driving), improved mood, greater locus of control, and enhanced quality of life.
Targeting HIV-Related Neurocognitive Impairments with Cognitive Training Strategies: Insights from the Cognitive Aging Literature. [2021]Approximately 50% of older adults with HIV meet the Frascati diagnostic criteria of HIV-associated neurocognitive disorders (HAND) which can interfere with everyday function such as medication adherence, employment, and driving ability, thus reducing quality of life. As the number of older adults with HIV continues to grow, many will become vulnerable to cognitive frailty, especially as they experience multimorbidities, polypharmacy, and geriatric syndromes. Healthcare professionals need strategies to prevent, remediate, and compensate for cognitive losses observed in memory, language, executive functioning, and speed of processing. Sadly, there are no standard protocols or accepted treatment/intervention guidelines to address HAND at this time. Fortunately, evidence from the cognitive aging literature indicates that cognitive training can protect and improve cognition in normal older adults and may even reduce the incidence of dementia/MCI. This article provides the scientific context in which computerized cognitive training approaches have been successfully used in older adults and provides examples of how these approaches have been translated to adults with HIV. Evidence from ongoing clinical trials are also presented that suggest that reversing a diagnosis of HAND may be possible. Recommendations for clinical practice and research are provided.