老年HIV阳性成年人的日常多任务处理能力：神经行为关联及元认知的中介作用。
Everyday Multitasking Abilities in Older HIV+ Adults: Neurobehavioral Correlates and the Mediating Role of Metacognition.
作者信息
Fazeli P L, Casaletto K B, Woods S P, Umlauf A, Scott J C, Moore D J
机构信息
Department of Family, Community and Health Systems, School of Nursing, Birmingham, University of Alabama at Birmingham, Birmingham, AL, USA.
University of California, San Francisco, CA, USA.
出版信息
Arch Clin Neuropsychol. 2017 Dec 1;32(8):917-928. doi: 10.1093/arclin/acx047.
OBJECTIVE
The prevalence of older adults living with HIV is rising, as is their risk for everyday functioning problems associated with neurocognitive dysfunction. Multitasking, the ability to maintain and carry out subgoals in support of a larger goal, is a multidimensional skill ubiquitous during most real-life tasks and associated with prefrontal networks that are vulnerable in HIV. Understanding factors associated with multitasking will improve characterization of HIV-associated neurocognitive disorders. Metacognition is also associated with frontal systems, is impaired among individuals with HIV, and may contribute to multitasking.
METHOD
Ninety-nine older (≥50 years) adults with HIV completed: the Everyday Multitasking Test (MT), a performance-based measure during which participants concurrently attempt four everyday tasks (e.g., medication management) within a time limit; a comprehensive neuropsychological battery; measures of metacognition regarding their MT performance (e.g., metacognitive knowledge and online awareness).
RESULTS
Better global neuropsychological performance (i.e., average T-score across all domains) was associated with better Everyday MT total scores (rho = 0.34; p < .001), as was global metacognition (rho = 0.37, p < .01). Bootstrapping mediation analysis revealed global metacognition was a significant partial mediator between neurocognition and Everyday MT (b = 0.09, 95% confidence interval [CI] = 0.01, 0.25). Specifically, metacognitive knowledge (but not online awareness) drove this mediation (b = 0.13, 95% CI = 0.03, 0.27).
CONCLUSIONS
Consistent with findings among younger persons with HIV, neuropsychological performance is strongly associated with a complex, laboratory-based test of everyday multitasking, and metacognition of task performance was a pathway through which successful multitasking occurred. Interventions aimed at modifying metacognition to improve daily functioning may be warranted among older adults with HIV.
目的
感染艾滋病毒的老年人患病率正在上升，他们出现与神经认知功能障碍相关的日常功能问题的风险也在增加。多任务处理是一种多维技能，即在支持更大目标的同时维持并执行子目标的能力，在大多数现实生活任务中普遍存在，且与艾滋病毒感染中易受损的前额叶网络相关。了解与多任务处理相关的因素将有助于更好地描述与艾滋病毒相关的神经认知障碍。元认知也与额叶系统相关，在感染艾滋病毒的个体中受损，并且可能有助于多任务处理。
方法
99名年龄较大（≥50岁）的艾滋病毒感染者完成了：日常多任务测试（MT），这是一项基于表现的测试，参与者需要在规定时间内同时尝试四项日常任务（例如，药物管理）；一套全面的神经心理测试；关于他们MT表现的元认知测量（例如，元认知知识和在线意识）。
结果
更好的整体神经心理表现（即所有领域的平均T分数）与更好的日常MT总分相关（rho = 0.34；p <.001），整体元认知也是如此（rho = 0.37，p <.01）。自举中介分析显示，整体元认知是神经认知与日常MT之间的显著部分中介（b = 0.09，95%置信区间[CI] = 0.01，0.25）。具体而言，元认知知识（而非在线意识）驱动了这种中介作用（b = 0.13，95%CI = 0.03，0.27）。
结论
与感染艾滋病毒的年轻人的研究结果一致，神经心理表现与一项基于实验室的复杂日常多任务测试密切相关，任务表现的元认知是成功进行多任务处理的一条途径。对于感染艾滋病毒的老年人，可能有必要采取旨在改变元认知以改善日常功能的干预措施。
Zotero 插件