The Impact of Neuropsychological Performance on Everyday Functioning Between Older and Younger Adults With and Without HIV

Abstract

In this cross-sectional study, a community-based sample of 162 younger and older adults with and without HIV was compared on neuropsychological and everyday functioning measures. In the HIV sample, the relationship between cognition, everyday functioning, and HIV biomarkers was also examined. A battery of cognitive tests were completed along with 2 laboratory measures of everyday functioning and 1 measure of HIV medication adherence. Main effects for age and HIV were found on several neuropsychological measures and on the Timed Instrumental Activities of Daily Living test; those who were older or who had HIV exhibited poorer performance. Although age × HIV interactions were not observed, older adults with HIV as a group performed worse on 8 out of the 9 neuropsychological and everyday functioning measures. Few of these neuropsychological and everyday measures were related to HIV biomarkers (e.g., CD4+ T-cell count). Implications for nursing practice and research are posited.

The Potential of Computerized Cognitive Training on HIV-Associated Neurocognitive Disorder: A Case Comparison Study

“…In conclusion, as cognitive abilities begin to decline with age, concerns emerge about more profound cognitive declines in older adults with HIV (Vance, Fazeli, & Gakumo, 2013). Fortunately, prior work already shows that SOP training can improve this cognitive ability and improve everyday functioning in middle-aged (40+) and older adults with HIV in the short-term (Vance et al, 2012), and in the long-term for normal community-dwelling older adults (Ross et al, 2016).…”

“…One pressing issue is HIV-Associated Neurocognitive Disorder (HAND), which occurs in nearly 50% of adults with HIV (Heaton et al, 2010). The severity and prevalence of HAND may also increase with the onset of age-related neurological insults (e.g., transient ischemic attack), thus compromising everyday function such as medication adherence and driving safety (Vance, Fazeli, & Gakumo, 2013). The mechanisms leading to HAND are varied and complex, and may include neuroinflammation, depression, substance abuse, and poor mental stimulation.…”

Cognitive Functioning In Adults Aging With HIV: A Cross-Sectional Analysis Of Cognitive Subtypes And Influential Factors

“…Several studies have provided evidence of lower cognitive performance for HIV-positive (HIV+) individuals compared to their HIV-negative (HIV-) counterparts in the domains of psychomotor functioning, attention, processing speed, executive functioning, and memory, reflecting a pattern of dysfunction of frontal-subcortical circuitry 1-6 . These cognitive domains are also subject to declines in normal aging 7 .…”

Neuropsychological profiles of adults and older adults with HIV

“…Woods et al (2009) and Levine et al (2008) espoused the idea that one domain of overlap on tasks measuring attention is psychomotor speed and speed of information processing. Given that impairment in various neuropsychological domains, particularly in speed of mental processing, have been observed in HIV+ adults and older adults, this aspect needs consideration when interpreting performance (Vance et al, 2013). In the current study, performance on simple untimed and complex timed attention tasks without psychomotor demands (DRS-2 Attention and Stroop Test) indicated no significant differences between the groups.…”