“The key question is not whether [lifestyle] interventions will improve brain health in HIV, but how we can improve adherence to the most promising interventions in people experiencing brain health challenges.”
As a physical therapist, Gilead/CTN Postdoctoral Fellow Dr. Adria Quigley has always been fascinated by how the brain works. Her interest in cognitive functioning in people living with HIV specifically was first piqued during her Master’s program at the University of Toronto. “I conducted a research project with Dr. Stephanie Nixon where we interviewed older men living with HIV to find out their lived experiences with cognitive impairment,” she explains.
After she graduated, Dr. Quigley worked as a physical therapist for nine years, two of which were spent working in a hospital in Saskatoon treating young women dying of AIDS. “That experience highlighted the inequalities and racism within our health care system and encouraged me to pursue my PhD,” she states. “Witnessing the intersecting effects of these inequities on HIV and related comorbidities, including cognitive impairment, compelled me to take the next step into research.”
Cognitive impairment can have a significant impact on the lives of people living with HIV. It can affect work performance, driving ability, and social interactions. But there are some potential treatment options. Dr. Quigley explains that exercise can help improve cognitive functioning in people with many health-related conditions. “During my PhD, I conducted a pilot trial investigating the impact of yoga on cognitive ability among people living with HIV. The results indicated that the trial and yoga program were feasible and enjoyable, and participants in the yoga group showed improvements in self-reported cognition,” she says.
During her current fellowship with the CTN, Dr. Quigley will build on the extensive work done by the CTN 273: Brain Health Now! study team, highlighting how lifestyle changes can benefit cognitive ability in people living with HIV. However, there are some barriers to implementation, as Dr. Quigley explains: “Sustained lifestyle change is hard for everyone, but may be especially so for those living with a chronic condition that affects cognitive ability, eroding the very functions required to effectively conduct the behaviours needed to achieve goals. As such, the key question is not whether interventions will improve brain health in HIV, but how we can improve adherence to the most promising interventions in people experiencing brain health challenges.”
Supervised by CTN Investigator Dr. Marie-Josée Brouillette and McGill University Professor Dr. Nancy Mayo, Dr. Quigley will test an innovative approach to enhance adherence to lifestyle interventions. “We hope to determine whether goal-setting training before a healthy lifestyle program promotes greater uptake of health recommendations, achievement of health-related goals, and better brain health and general health outcomes compared to those who participate in the healthy lifestyle program alone,” she says. “If successful, goal-setting programs could be implemented as a support for exercise interventions for people with cognitive impairment across many clinical populations.”
Looking ahead, Dr. Quigley foresees her research interests including assessment tools and healthy lifestyle strategies for people living with HIV and physical or cognitive impairments. We are looking forward to seeing where her work takes her!
Want to learn more? You can watch Dr. Quigley present her research project at the 2020 CTN Fall Meeting.