Foley Jessica M, Ettenhofer Mark L, Kim Michelle S, Behdin Nina, Castellon Steven A, Hinkin Charles H
Department of Psychiatry and Biobehavioral Sciences, UCLA Semel Institute for Neuroscience and Human Behavior, Los Angeles, California, USA.
Appl Neuropsychol Adult. 2012;19(1):16-25. doi: 10.1080/09084282.2011.595601.
The present study examined the impact of cognitive reserve in maintaining intact neuropsychological (NP) function among older HIV-positive individuals, a uniquely at-risk subgroup. Participants included 129 individuals classified by HIV serostatus, age group, and NP impairment. A three-way analysis of variance (ANOVA) followed by a series of within-group ANOVA and multiple regression analyses were conducted to investigate the pattern of cognitive reserve (vs. other protective) influence among groups with varying risks of NP impairment. Results indicated a significant age × HIV status interaction, with older HIV-positive individuals demonstrating higher cognitive reserve than subgroups with less risk for NP compromise (younger age and/or HIV-negative). Results demonstrated higher cognitive reserve specific to NP-intact older HIV-positive individuals. Within this group, the interaction of younger age and higher cognitive reserve independently contributed to cognitive status when controlling for psychiatric, immunological, and psychosocial protective mechanisms, suggesting the importance of cognitive reserve beyond other protective mechanisms in maintaining optimal NP functioning in those individuals most at risk. Alongside younger age, factors contributing to cognitive reserve (i.e., education and estimated premorbid intelligence) may provide substantial benefit for older HIV-positive adults who are at high risk for NP compromise.
本研究考察了认知储备对老年HIV阳性个体（一个独特的高危亚组）维持完整神经心理学（NP）功能的影响。参与者包括129名根据HIV血清学状态、年龄组和NP损伤进行分类的个体。进行了三因素方差分析（ANOVA），随后进行了一系列组内ANOVA和多元回归分析，以研究在NP损伤风险不同的组中认知储备（相对于其他保护因素）的影响模式。结果表明存在显著的年龄×HIV状态交互作用，老年HIV阳性个体比NP受损风险较低的亚组（年龄较小和/或HIV阴性）表现出更高的认知储备。结果显示，NP功能完整的老年HIV阳性个体具有更高的认知储备。在该组中，控制精神、免疫和社会心理保护机制时，年龄较小和认知储备较高的交互作用独立地影响认知状态，这表明在维持那些高危个体的最佳NP功能方面，认知储备比其他保护机制更重要。除年龄较小外，有助于认知储备的因素（即教育和预估病前智力）可能会为NP受损风险较高的老年HIV阳性成年人带来实质性益处。
