Rush Alzheimer's Disease Center, Rush University, Chicago, IL, USA.
Department of Psychology, University of Houston, Houston, TX, USA.
J Clin Exp Neuropsychol. 2024 May;46(4):341-351. doi: 10.1080/13803395.2024.2350577. Epub 2024 May 4.
People living with HIV (PLWH) often experience difficulties in everyday functioning, which can arise in part from deficits in the strategic/executive aspects of prospective memory (PM). Using Suchy's Contextually Valid Executive Assessment (ConVExA) framework, this study sought to determine whether the contextual factors of busyness and routine moderate the relationship between the strategic/executive aspects of PM and everyday functioning in older PLWH.
Participants in this cross-sectional analysis were 145 PLWH aged 50 years and older who had completed the Martin and Park Environmental Demands (MPED) questionnaire of routine and busyness, the performance-based Cambridge Test of Prospective Memory, and self-report measures of activities of daily living (ADLs) and cognitive symptoms in daily life.
Multiple regression analyses covarying for relevant comorbidities showed that higher levels of busyness - but not routine - were associated with more frequent cognitive symptoms in daily life. Neither busyness nor routine interacted with PM in association with cognitive symptoms. However, routine and a strategic/executive measure of PM interacted in predicting ADLs; specifically, the association between time-based PM and ADLs was stronger in persons with higher levels of routine in their daily lives. Parallel analyses with less executively-demanding event-based PM were null and small.
Overall, findings provided mixed - and unexpected - evidence for the associations between contextual factors (i.e. routine and busyness), everyday functioning, and PM in this sample of older adults with HIV disease. Results and clinical implications are interpreted and discussed in the framework of the ConVExA model.
感染艾滋病毒的人(PLWH)在日常生活中经常遇到困难,这部分可能是由于前瞻性记忆(PM)的策略/执行方面存在缺陷。本研究采用 Suchy 的情境有效执行评估(ConVExA)框架,旨在确定忙碌和常规这两个情境因素是否会调节 PM 的策略/执行方面与老年 PLWH 日常功能之间的关系。
本横断面分析的参与者是 145 名年龄在 50 岁及以上、完成了 Martin 和 Park 环境需求(MPED)问卷中的常规和忙碌、基于表现的剑桥前瞻性记忆测试以及日常生活活动(ADL)和日常生活认知症状的自我报告措施的 PLWH。
协方差多变量回归分析显示,忙碌程度较高 - 而不是常规 - 与日常生活中更频繁的认知症状有关。忙碌和常规都不会与 PM 相互作用与认知症状有关。然而,常规和 PM 的一项策略/执行测量在预测 ADL 方面相互作用;具体来说,基于时间的 PM 与 ADL 之间的关联在日常生活中常规水平较高的人群中更强。与执行要求较低的事件基 PM 的平行分析为零且较小。
总体而言,这些发现为该样本中 HIV 疾病老年患者中情境因素(即常规和忙碌)、日常功能和 PM 之间的关联提供了混合的 - 出乎意料的 - 证据。结果和临床意义在 ConVExA 模型的框架内进行了解释和讨论。