Comparative effects of two community-based exercise programs on cognition, balance, mobility, and quality of life of older people living with HIV/AIDS: A pilot randomized controlled trial

Approximately 50% of people living with HIV (and as many as 80% over the age of 50) have difficulties with cognitive functions such as memory and thinking that can have a profound negative impact on activities of daily living and quality of life. Problems with memory and thinking are also associated with forgetting to take anti-retroviral drugs and experiencing challenges to balance, walking and mental health (anxiety and depression). There is increasing evidence that, in the general population, exercise has positive effects on cognition, physical functioning and mental health. In the words of one researcher, "Exercise is like a biological sledgehammer that affects many different systems in the body." Despite the recognition of multiple therapeutic benefits of exercise, little attention has been paid to its possible effects on cognition in people living with HIV. We have assembled a team of HIV and Aboriginal community leaders, knowledge users, and researchers to begin to tackle this gap in evidence. The purpose of the proposed pilot study is to compare the effects of two 12-week, randomly assigned, community-based, exercise programs - yoga and standard fitness training (strengthening and aerobic exercise) - on cognition, balance, walking, mental health and quality of life in 20 people >50 years of age living with HIV in the Halifax area. Each week An Aboriginal elder will offer the participants an opening prayer and a smudging ceremony at the start of the exercise session. Yoga is of particular interest to us because it encompasses not only the physical but also spiritual, emotional, and mental dimensions of life. As such, it has tremendous potential to help stave off some of the devastating consequences of the HIV infection. If the findings of this pilot study are promising, we will extend the study by conducting a full-scale, multi-site investigation.