A Randomized Clinical Trial on the Impact of Individually Targeted Computerized Cognitive Training on Quality of Life Indicators in Adults With HIV-Associated Neurocognitive Disorder in the Southeastern United States

Abstract

HIV-associated neurocognitive disorder (HAND) is experienced by 30% to 50% of people living with HIV (PLWH), potentially affecting their quality of life (QoL). In the Training on Purpose Study, we investigated whether targeted cognitive training can improve QoL in PLWH with HAND. Using a two-group experimental design, we randomized 109 adults with HAND to either (a) the Individualized-Targeted Cognitive Training group or (b) a no-contact control group. Those in the training group were assigned 10 hr of cognitive training per two selected cognitive domains (20 hr total) for which impairment was observed. Overall, two patterns emerged. First, significant improvements in measures of everyday cognitive complaints, depression, and mental health were consistently observed after the completion of many cognitive training protocols. Second, immediate and delayed spatial learning and memory training resulted in more significant indicators of QoL improvements compared with the other cognitive domain trainings. The findings suggest that some types of cognitive training may have advantages over others in improving aspects of QoL.

A 2-Year, Randomized, Clinical Trial Examining the Effects of Speed of Processing Cognitive Training on Quality-of-Life Indicators in Adults With HIV-Associated Neurocognitive Disorder in Birmingham, Alabama: Results of the Think Fast Study

“…Unfortunately, SOP training was not found to be effective in enhancing QoL in our sample. Nonetheless, consistent with other research (Vance et al, 2022), certain domain-specific cognitive training approaches have been shown to exert a greater influence on QoL indicators. Therefore, when clinicians provide recommendations regarding cognitive training for their HIV patients, it remains crucial to clearly communicate realistic expectations and limitations regarding transfer to QoL.…”

“…However, although SOP training wielded some effect on cognitive and everyday functioning in the Think Fast Study (Vance et al, 2023(Vance et al, , 2023a, these effects did not transfer to QoL indices. This result was surprising given the positive findings of other cognitive training studies (Vance et al, 2022;Wolinsky et al, 2010a). From a research perspective, this suggests several possibilities.…”

“…Upon reflection, SOP training may not be the best domain-specific cognitive training to improve QoL indicators in PWH with HAND. In the Training on Purpose Study, Vance et al (2022) randomized 109 PWH with HAND to a no-contact control group or to an individually targeted cognitive training group. Based on the participant's baseline neurocognitive performance, those in the individually targeted group received domain-specific cognitive training targeting two cognitive domains (10 hr for each domain) that specifically contributed to their HAND diagnosis, based on a specific algorithm that favored attention training and/or SOP training.…”

Health-Related Quality of Life in People Living With HIV With Cognitive Symptoms: Assessing Relevant Domains and Associations

“…Therefore, from the perspective of the regression analysis, conceptually these domains add little unique variance. This is the first study to measure illness-specific domains of HRQL among PLWH with cognitive symptoms and compliments work conducted by Vance et al 63 Corroborating qualitative work 19 we have quantitatively demonstrated the relevance of domains important to HRQL in PLWH with cognitive symptoms through factor analysis, regression, and correlational analyses. Given no interventions exist to improve cognition for the majority of PLWH experiencing cognitive symptoms, focusing on improving broader indicators of wellbeing is important.…”