Del Bene Victor A, Fazeli Pariya L, Blake Jason A, Li Wei, Collette Christopher, Triebel Kristen L, Byun Jun Y, Jacob Alexandra E, Kamath Vidyulata, Vance David E
Department of Neurology, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL 35294, USA.
School of Nursing, University of Alabama at Birmingham, Birmingham, AL 35294, USA.
Arch Clin Neuropsychol. 2025 Jan 8. doi: 10.1093/arclin/acae126.
Cognitive intra-individual variability (IIV) is a sensitive marker of neuropathology and is increased in people with HIV (PWH). In a sample of PWH from the United States Deep South, we examined the relationship of cognitive IIV with cognitive impairment and social determinants of health (SDoH). This secondary analysis included 131 PWH from a larger cognitive training protocol. Our primary outcome measure was the coefficient of variation (CoV). We also included the individual standard deviation (iSD), with both calculated from demographically adjusted T-scores and unadjusted sample-based scores. Mixed-effects models investigated the relationship between IIV and cognitive impairment severity (i.e., Global Rating Score), SDoH, and clinical variables. Bivariate correlations were used to further explore these relationships. Greater cognitive IIV was associated with greater cognitive impairment in PWH, when accounting for demographic factors. When IIV is calculated from the sample, then IIV is no longer associated with cognitive impairment, but is associated with race (>IIV in Black and African American participants). Demographically adjusted IIV is associated with global cognition, Wide Range Achievement Test-Fourth Edition reading score, and viral load (iSD only). No correlations were significant when using the unadjusted sample-based IIV metrics. In PWH from the Deep South, greater cognitive variability is seen in those with greater cognitive impairment, in Black participants, and in those with lower reading scores. Further research on the psychometric properties of IIV in HIV and other populations is needed, as results varied depending on the normative adjustments.
认知个体内变异性（IIV）是神经病理学的一个敏感标志物，在HIV感染者（PWH）中有所增加。在来自美国南部腹地的PWH样本中，我们研究了认知IIV与认知障碍及健康的社会决定因素（SDoH）之间的关系。这项二次分析纳入了来自一个更大的认知训练方案的131名PWH。我们的主要结局指标是变异系数（CoV）。我们还纳入了个体标准差（iSD），两者均根据经人口统计学调整的T分数和未经调整的基于样本的分数计算得出。混合效应模型研究了IIV与认知障碍严重程度（即总体评分）、SDoH和临床变量之间的关系。双变量相关性用于进一步探讨这些关系。在考虑人口统计学因素时，PWH中更大的认知IIV与更严重的认知障碍相关。当从样本计算IIV时，IIV不再与认知障碍相关，但与种族相关（黑人和非裔美国参与者的IIV更高）。经人口统计学调整的IIV与总体认知、《广泛成就测验第四版》阅读分数和病毒载量（仅iSD）相关。使用未经调整的基于样本的IIV指标时，没有相关性显著。在来自南部腹地的PWH中，认知障碍更严重者、黑人参与者以及阅读分数较低者的认知变异性更大。由于结果因规范调整而异，因此需要对HIV及其他人群中IIV的心理测量特性进行进一步研究。
