Department of Psychiatry and Biobehavioral Sciences, UCLA School of Medicine, Los Angeles, CA 90095, USA.
J Clin Exp Neuropsychol. 2013;35(1):49-58. doi: 10.1080/13803395.2012.747596. Epub 2012 Dec 14.
Approximately 50% of individuals with HIV report cognitive deficits that can affect social or occupational functioning. The present study used a longitudinal design (1 year) to examine the relationship between cognitive factors and incidental functional deficits in medication management and driving ability among a cohort of 101 HIV+ participants. Participants were classified into groups of functionally "stable" and "disabled" for each laboratory-based functional task (i.e., Medication Management Task-Revised, MMT-R, and PC-based driving simulator). We hypothesized that participants who exhibited a functional deficit in either MMT-R or driving at follow-up assessment would demonstrate significantly poorer baseline cognitive performance at study entry than participants who remained functionally stable. As hypothesized, participants who demonstrated significantly lower baseline performance in learning/memory and executive functioning also demonstrated functional disability on the MMT-R at follow-up when compared to functionally stable participants. Poor baseline performance in speed of information processing was associated with a deficit in driving ability at follow-up assessment. Our results suggest that lower baseline cognitive functioning predicts downstream functional disability, and that deficits in learning/memory and information processing speed are particularly predictive of deficits in medication management and driving ability.
大约 50%的 HIV 感染者报告存在认知缺陷,这可能会影响他们的社交或职业功能。本研究采用纵向设计(1 年),在 101 名 HIV+参与者的队列中,考察认知因素与药物管理和驾驶能力方面偶然发生的功能缺陷之间的关系。参与者根据每个基于实验室的功能任务(即,修订后的药物管理任务,MMT-R 和基于 PC 的驾驶模拟器)被分为“功能稳定”和“功能障碍”两组。我们假设,在随访评估中在 MMT-R 或驾驶中表现出功能缺陷的参与者,其研究入组时的认知表现明显比功能稳定的参与者差。正如假设的那样,与功能稳定的参与者相比,在学习/记忆和执行功能方面表现出明显较低的基线表现的参与者,在随访时也在 MMT-R 上表现出功能障碍。信息处理速度的基线表现较差与随访评估时的驾驶能力缺陷有关。我们的研究结果表明,较低的基线认知功能预测下游的功能障碍,而学习/记忆和信息处理速度的缺陷则特别预测药物管理和驾驶能力的缺陷。