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Fuentes A, Coulehan K, Byrd D, Arentoft A, Miranda C, Arce Rentería M, Monzones J, Rosario A, Rivera Mindt M. Neurocognitive, Sociocultural, and Psychological Factors Impacting Medication Beliefs Among HIV-Seropositive Latinx Adults. AIDS Patient Care STDS 2023; 37:616-625. [PMID: 38096115 PMCID: PMC10732168 DOI: 10.1089/apc.2023.0173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2023] Open
Abstract
Among Latinx people living with HIV (PLWH), neurocognitive (NC) function, culture, and mental health impact medication adherence. Similarly, health beliefs and attitudes play a role in health care barriers and health behaviors. Research has not examined the effect that compromised neurocognition, sociocultural factors, and mental health have on health beliefs and attitudes. This is especially relevant for Latinx PLWH who are disproportionately impacted by HIV, given that sociocultural factors may uniquely impact HIV-related NC and psychological sequelae. This study investigated the associations between neurocognition, sociocultural factors, mental health, health beliefs, and health attitudes among Latinx HIV-seropositive adults. Within a sample of 100 Latinx PLWH, better verbal learning and executive functioning abilities were associated with more positive attitudes about the benefits of medications and memory for medications. In terms of sociocultural factors, higher English language competence was related to better self-reported memory for medications, and overall, higher US acculturation was associated with more positive attitudes toward health professionals. Depressive symptomatology was negatively associated with attitudes toward medications and health professionals, as well as with self-reported memory for medications. These findings highlight the important interplay between NC, sociocultural, psychological factors, and health beliefs among Latinx PLWH. Adherence intervention strategies and suggestions for dispensing medical information are presented for clinicians and health care practitioners.
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Affiliation(s)
- Armando Fuentes
- Department of Psychology, Fordham University, New York, New York, USA
| | - Kelly Coulehan
- Department of Neurology, Stony Brook University Hospital, Stony Brook, New York, USA
| | - Desiree Byrd
- Department of Psychology, Queens College, Flushing, New York, USA
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Alyssa Arentoft
- Department of Psychology, California State University, Northridge, California, USA
| | - Caitlin Miranda
- Department of Neurology, Stony Brook University Hospital, Stony Brook, New York, USA
| | - Miguel Arce Rentería
- Department of Neurology, Columbia University Medical Center, New York, New York, USA
| | - Jennifer Monzones
- Department of Psychiatry and Behavioral Sciences, University of New Mexico Hospital, Albuquerque, New Mexico, USA
| | - Ana Rosario
- Department of Psychology, Fordham University, New York, New York, USA
| | - Monica Rivera Mindt
- Department of Psychology, Fordham University, New York, New York, USA
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
- Latin American and Latino Studies Institute, and Department of African and African American Studies, Fordham University, Bronx, New York, USA
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Thompson JL, Sheppard DP, Matchanova A, Morgan EE, Loft S, Woods SP. Subjective cognitive decline disrupts aspects of prospective memory in older adults with HIV disease. NEUROPSYCHOLOGY, DEVELOPMENT, AND COGNITION. SECTION B, AGING, NEUROPSYCHOLOGY AND COGNITION 2023; 30:582-600. [PMID: 35412440 PMCID: PMC9554043 DOI: 10.1080/13825585.2022.2065241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 04/07/2022] [Indexed: 05/10/2023]
Abstract
Subjective cognitive decline (SCD) is a risk factor for dementia that may occur at higher rates in people with HIV (PWH). Prospective memory (PM) is an aspect of cognition that may help us better understand how SCD impacts daily life. Paricipants were 62 PWH aged ≥ 50 years and 33 seronegative individuals. SCD was operationalized as normatively elevated cognitive symptoms on standardized questionnaires, but with normatively unimpaired performance-based cognition and no current affective disorders. PM was measured with the Comprehensive Assessment of Prospective Memory (CAPM), the Cambridge Test of Prospective Memory (CAMPROMPT), and an experimental computerized time-based PM task. A logistic regression revealed that older PWH had a three-fold increased likelihood for SCD. Among the PWH, SCD was associated with more frequent PM symptoms and poorer accuracy on the time-based scale of the CAMPROMPT. These findings suggest that SCD disrupts PM in older PWH.
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Affiliation(s)
| | - David P. Sheppard
- Mental Illness, Research, Education, and Clinical Care (MIRECC), Veterans Affairs Puget Sound Health Care System, Seattle, WA 98108, USA
| | | | - Erin E. Morgan
- Department of Psychiatry, University of California San Diego, San Diego, CA 92103, USA
| | - Shayne Loft
- School of Psychological Science, University of Western Australia, Perth, WA 6009, Australia
| | - Steven Paul Woods
- Department of Psychology, University of Houston, Houston, TX 77004, USA
- School of Psychological Science, University of Western Australia, Perth, WA 6009, Australia
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Beltran-Najera I, Mustafa A, Warren D, Salling Z, Misiura M, Woods SP, Dotson VM. Elevated frequency and everyday functioning implications of vascular depression in persons with HIV disease. J Psychiatr Res 2023; 160:78-85. [PMID: 36780803 PMCID: PMC10123762 DOI: 10.1016/j.jpsychires.2023.02.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Revised: 01/24/2023] [Accepted: 02/04/2023] [Indexed: 02/09/2023]
Abstract
Depression and cardiovascular disease are common and associated with one another in HIV disease. This study aimed to determine the frequency and everyday functioning implications of the clinical syndrome of vascular depression among people living with HIV (PLWH). Participants in this cross-sectional study included 536 PLWH and 272 seronegative individuals who completed a biomedical and psychiatric research evaluation. Vascular depression was operationalized as the current presence of: 1) two or more vascular conditions; and 2) depression as determined by a normative elevation on the Depression/Dejection subscale of the Profile of Mood States or a diagnosis of Major Depressive Disorder per the Composite International Diagnostic Interview. Everyday functioning was measured by both self- and clinician-rated activities of daily living. A logistic regression model showed that HIV was associated with a three-fold increased risk of vascular depression, independent of potential confounding factors. A second logistic regression model within the PLWH sample showed that PLWH with vascular depression had significantly greater odds of dependence in everyday functioning as compared to PLWH with either vascular disease or depression alone. The elevated frequency of vascular depression in PLWH is consistent with the vascular depression hypothesis from the late-life depression literature. The high rate of functional dependence among PLWH with vascular depression highlights the clinical importance of prospective work on this syndrome in the context of HIV disease.
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Affiliation(s)
- Ilex Beltran-Najera
- Department of Psychology, University of Houston, 126 Heyne Bldg., Houston, TX, 77204, USA
| | - Andrea Mustafa
- Department of Psychology, University of Houston, 126 Heyne Bldg., Houston, TX, 77204, USA
| | - Desmond Warren
- Department of Psychology, Georgia State University, P.O. Box 5010, Atlanta, GA, 30302, USA
| | - Zach Salling
- Department of Psychology, Georgia State University, P.O. Box 5010, Atlanta, GA, 30302, USA
| | - Maria Misiura
- Department of Psychology, Georgia State University, P.O. Box 5010, Atlanta, GA, 30302, USA
| | - Steven Paul Woods
- Department of Psychology, University of Houston, 126 Heyne Bldg., Houston, TX, 77204, USA
| | - Vonetta M Dotson
- Department of Psychology, Georgia State University, P.O. Box 5010, Atlanta, GA, 30302, USA; Gerontology Institute, Georgia State University, P.O. Box 3984, Atlanta, GA, 30302, USA.
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Sheppard DP, Rau HK, Werhane ML, Fonseca LM, Chaytor NS, Peskind ER, Pagulayan KF. Associations between Intra-Individual Neurocognitive Variability and Prospective Memory in Veterans with Mild Traumatic Brain Injury History and Posttraumatic Stress Disorder. ARCHIVES OF CLINICAL NEUROPSYCHOLOGY : THE OFFICIAL JOURNAL OF THE NATIONAL ACADEMY OF NEUROPSYCHOLOGISTS 2022; 37:1221-1227. [PMID: 35470369 DOI: 10.1093/arclin/acac014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/21/2022] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Mild traumatic brain injury (mTBI) and posttraumatic stress disorder (PTSD) frequently co-occur and are associated with neurocognitive intra-individual variability (IIV) and difficulty with prospective memory (PM). The current study aimed to examine associations between IIV and PM in this comorbid group. METHOD Fifty veterans with a history of blast mTBI and current comorbid PTSD completed a standardized neurocognitive battery to measure IIV, and the Memory for Intentions Screening Test measuring PM. RESULTS Adjusting for age, education, and race, higher IIV was associated with poorer time-based PM (p < .001, f2 = .34), but not event-based PM. In a subset of the sample with self-report data, higher IIV was associated with poorer self-reported retrospective memory, but not PM. CONCLUSIONS Cognitive variability on a standardized neuropsychological battery was associated with strategically demanding PM, which is an ecologically relevant ability and highlights the possible connection between subtle cognitive difficulties in-clinic and those experienced in daily life.
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Affiliation(s)
- David P Sheppard
- Veterans Affairs (VA) Northwest (VISN 20) Mental Illness, Research, Education, and Clinical Center (MIRECC), Veterans Affairs Puget Sound Health Care System, Seattle, WA, USA
| | - Holly K Rau
- Veterans Affairs (VA) Northwest (VISN 20) Mental Illness, Research, Education, and Clinical Center (MIRECC), Veterans Affairs Puget Sound Health Care System, Seattle, WA, USA
| | - Madeleine L Werhane
- Veterans Affairs (VA) Northwest (VISN 20) Mental Illness, Research, Education, and Clinical Center (MIRECC), Veterans Affairs Puget Sound Health Care System, Seattle, WA, USA.,Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA, USA
| | - Luciana Mascarenhas Fonseca
- Department of Community and Behavioral Health, Washington State University Elson S. Floyd College of Medicine, Spokane, WA, USA
| | - Naomi S Chaytor
- Department of Community and Behavioral Health, Washington State University Elson S. Floyd College of Medicine, Spokane, WA, USA
| | - Elaine R Peskind
- Veterans Affairs (VA) Northwest (VISN 20) Mental Illness, Research, Education, and Clinical Center (MIRECC), Veterans Affairs Puget Sound Health Care System, Seattle, WA, USA.,Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA, USA
| | - Kathleen F Pagulayan
- Veterans Affairs (VA) Northwest (VISN 20) Mental Illness, Research, Education, and Clinical Center (MIRECC), Veterans Affairs Puget Sound Health Care System, Seattle, WA, USA.,Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA, USA
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Nyundo AA. Neurocognitive decline as a major predictor of nonadherence to antiretroviral therapy among adults living with HIV in Dodoma region, central Tanzania. Health Sci Rep 2022; 5:e669. [PMID: 35686198 PMCID: PMC9172586 DOI: 10.1002/hsr2.669] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Revised: 05/07/2022] [Accepted: 05/17/2022] [Indexed: 11/08/2022] Open
Affiliation(s)
- Azan A. Nyundo
- Department of Psychiatry and Mental Health, School of Medicine The University of Dodoma Dodoma Tanzania
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The association between benzodiazepine use and greater risk of neurocognitive impairment is moderated by medical burden in people with HIV. J Neurovirol 2022; 28:410-421. [PMID: 35389174 PMCID: PMC9470605 DOI: 10.1007/s13365-022-01076-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2021] [Revised: 03/12/2022] [Accepted: 03/23/2022] [Indexed: 11/22/2022]
Abstract
Benzodiazepine use is linked to neurocognitive impairment (NCI) in the general population and people with HIV (PWH); however, this relationship may depend on age-related factors such as medical comorbidities, which occur at an elevated rate and manifest earlier in PWH. We retrospectively examined whether chronological age or medical burden, a clinical marker for aging, moderated the relationship between benzodiazepine use and NCI in PWH. Participants were 435 PWH on antiretroviral therapy who underwent neurocognitive and medical evaluations, including self-reported current benzodiazepine use. A medical burden index score (proportion of accumulated multisystem deficits) was calculated from 28 medical deficits. Demographically corrected cognitive deficit scores from 15 neuropsychological tests were used to calculate global and domain-specific NCI based on established cut-offs. Logistic regressions separately modeled global and domain-specific NCI as a function of benzodiazepine x age and benzodiazepine x medical burden interactions, adjusting for current affective symptoms and HIV disease characteristics. A statistically significant benzodiazepine x medical burden interaction (p = .006) revealed that current benzodiazepine use increased odds of global NCI only among those who had a high medical burden (index score > 0.3 as indicated by the Johnson–Neyman analysis), which was driven by the domains of processing speed, motor, and verbal fluency. No age x benzodiazepine interactive effects on NCI were present. Findings suggest that the relationship between BZD use and NCI among PWH is specific to those with greater medical burden, which may be a greater risk factor for BZD-related NCI than chronological age.
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Sumbul-Sekerci B, Hanagasi HA, Bilgic B, Tufekcioglu Z, Gurvit H, Emre M. Medication management and treatment adherence in Parkinson's disease patients with mild cognitive impairment. Acta Neurol Belg 2022:10.1007/s13760-022-01916-1. [PMID: 35325434 DOI: 10.1007/s13760-022-01916-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 03/03/2022] [Indexed: 11/28/2022]
Abstract
INTRODUCTION The key feature that distinguishes mild cognitive impairment (MCI) from dementia is the absence of significant functional decline because of cognitive impairment. In Parkinson's disease patients (PD) with MCI (PD-MCI), the effect of cognitive impairment on complex instrumental daily activities, such as medication management, is not well established. METHOD 26 patients with PD-MCI (diagnosed to Level 2 Movement Disorders Society diagnostic criteria) and 32 idiopathic PD patients without cognitive impairment participated in the study. A detailed neuropsychological testing battery (including tests for attention and working memory, executive functions, language, visuospatial functions, episodic memory) and various prospective memory tasks were applied to the patients. Medication taking behaviors were evaluated using two different methods based on the performance (medication management ability assessment) and self-reporting (adherence scale). RESULTS The PD-MCI group obtained significantly lower scores in medication management assessment and made more mistakes on following prescription instructions (e.g., they took more or less tablets and did not use medications as instructed with regard to meal times). Cognitive areas predicting success in medication management performance were language, event-based prospective memory and visuospatial functions. There was no significant difference between the two groups' self-reporting of adherence. CONCLUSION Mild cognitive impairment in patients with PD adversely affects medication management. Diagnosing MCI in PD is important to ensure that the appropriate measures can be taken to provide support and improve the medication management process. Adherence assessments based on self-reporting may not provide reliable and sensitive information in patients with PD-MCI.
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Affiliation(s)
- Betul Sumbul-Sekerci
- Department of Neuroscience, Aziz Sancar Institute of Experimental Medicine, Istanbul University, Istanbul, Turkey.
- Department of Clinical Pharmacy, Faculty of Pharmacy, Bezmialem Vakıf University, Istanbul, Turkey.
| | - Hasmet A Hanagasi
- Behavioral Neurology and Movement Disorders Unit, Department of Neurology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Basar Bilgic
- Behavioral Neurology and Movement Disorders Unit, Department of Neurology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Zeynep Tufekcioglu
- Behavioral Neurology and Movement Disorders Unit, Department of Neurology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Hakan Gurvit
- Behavioral Neurology and Movement Disorders Unit, Department of Neurology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Murat Emre
- Behavioral Neurology and Movement Disorders Unit, Department of Neurology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
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Sun J, Zhang K, Su X, Zhang Q, Wang Z, He L, Hu L. The Chinese version of the Memory for Intentions Test (MIST): development and evaluation of its reliability and concurrent validity. Clin Neuropsychol 2022:1-19. [PMID: 35266859 DOI: 10.1080/13854046.2022.2047791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
This study aims to develop a simplified Chinese version of the "Memory for Intentions Test" (MIST), evaluate its reliability and concurrent validity, explore the inter-relationships among the MIST variables and the relationships between the MIST variables and socio-demographic factors. Two hundred healthy, Chinese-speaking adults of the Han community participated in this study. Form A of the Chinese MIST and two prospective items of the Rivermead Behavioural Memory Test, Second Edition (RBMT-II, Chinese version) were administered to all participants to evaluate internal consistency, split-half reliability, and concurrent validity. Twenty of these participants were assessed twice on Form A with a two-week interval to examine test-retest reliability. They were also assessed on both Form A and Form B to examine alternate-form reliability. The findings of the study indicated good internal consistency (Cronbach's α = .833) and excellent split-half reliability (r = .924-.930) among the six subscales of the Chinese MIST, although the internal consistency was low (Cronbach's α = .129) for individual PM trials. We also found adequate concurrent validity (ρ = .722, p< .001), test-retest reliability (ρ = .716, p < .001), and alternate-form reliability (ρ= .828, p < .001). The Chinese MIST demonstrated suitable reliability and concurrent validity in the Chinese-speaking population. The present study provides a new standardized prospective memory test for the Chinese population, which would enhance future clinical research in this field on the Chinese mainland.
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Affiliation(s)
- Junyuan Sun
- Department of Psychiatry, School of Mental Health, Jining Medical University, Jining, China
| | - Kai Zhang
- Department of Psychiatry, School of Clinical Medicine, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Xianbiao Su
- Department of Psychiatry, Shandong Mental Health Center, Cheeloo Chollege of Medicine, Shandong University, Jinan, China
| | - Qunlei Zhang
- Department of Psychiatry, Shandong Mental Health Center, Cheeloo Chollege of Medicine, Shandong University, Jinan, China
| | - Ziyang Wang
- Department of Psychiatry, School of Clinical Medicine, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Long He
- Department of Psychiatry, School of Clinical Medicine, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Lei Hu
- Department of Psychiatry, Shandong Mental Health Center, Cheeloo Chollege of Medicine, Shandong University, Jinan, China
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Woolf-King SE, Sheinfil AZ, Ramos J, Foley JD, Moskal D, Firkey M, Kellen D, Maisto SA. A conceptual model of alcohol use and adherence to antiretroviral therapy: systematic review and theoretical implications for mechanisms of action. Health Psychol Rev 2022; 16:104-133. [PMID: 32757813 PMCID: PMC8972079 DOI: 10.1080/17437199.2020.1806722] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Alcohol consumption is one of the most prevalent correlates of antiretroviral therapy (ART) adherence, yet causal processes underlying this association remain largely unexplored. The goal of this systematic review was to develop a conceptual model that describes the causal effect of alcohol consumption on ART nonadherence. We reviewed 230 studies that examined the association between alcohol consumption and ART adherence with three primary aims: (1) to replicate and extend previous reviews of the literature, (2) to summarize and critique study designs capable of answering questions about temporal overlap and (3) to summarize potential mechanisms of action. A model of alcohol-associated ART nonadherence was proposed to guide future work, integrating general theories of ART adherence and theory on the psychological and behavioral effects of alcohol intoxication. The conceptual model describes two mechanistic processes-prospective memory impairment and interactive toxicity beliefs/avoidance behaviors-involved in alcohol-associated intentional and unintentional nonadherence, respectively. This model can be used to guide future research on the causal processes involved in the frequently observed correlation between alcohol consumption and adherence.
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Affiliation(s)
| | - Alan Z. Sheinfil
- Department of Psychology, Syracuse University, Syracuse, NY, USA
| | - Jeremy Ramos
- Department of Psychology, Syracuse University, Syracuse, NY, USA
| | - Jacklyn D. Foley
- Department of Psychology, Syracuse University, Syracuse, NY, USA
| | - Dezarie Moskal
- Department of Psychology, Syracuse University, Syracuse, NY, USA
| | - Madison Firkey
- Department of Psychology, Syracuse University, Syracuse, NY, USA
| | - David Kellen
- Department of Psychology, Syracuse University, Syracuse, NY, USA
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"Do I Have a Memory Problem? I Can't Recall": An Evaluation of Measurement Invariance in Subjective Reporting of Memory Symptoms among Persons with and without Objective HIV-Associated Memory Impairment. J Int Neuropsychol Soc 2022; 28:166-176. [PMID: 33952370 PMCID: PMC9011384 DOI: 10.1017/s1355617721000448] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Memory symptoms and objective impairment are common in HIV disease and are associated with disability. A paradoxical issue is that objective episodic memory failures can interfere with accurate recall of memory symptoms. The present study assessed whether responses on a self-report scale of memory symptoms demonstrate measurement invariance in persons with and without objective HIV-associated memory impairment. METHOD In total, 505 persons with HIV completed the Prospective and Retrospective Memory Questionnaire (PRMQ). Objective memory impairment (n = 141) was determined using a 1-SD cutoff on clinical tests of episodic memory. PRMQ measurement invariance was assessed by confirmatory factor analyses examining a one-factor model with increasing cross-group equality constraints imposed on factor loadings and item thresholds (i.e., configural, weak, and strong invariance). RESULTS Configural model fit indicated that identical items measured a one-factor model for both groups. Comparison to the weak model indicated that factor loadings were equivalent across groups. However, there was evidence of partial strong invariance, with two PRMQ item thresholds differing across memory impairment groups. Post hoc analyses using a 1.5-SD memory impairment cutoff (n = 77) revealed both partial weak and partial strong invariance, such that PRMQ item loadings differed across memory groups for three items. CONCLUSIONS The PRMQ demonstrated a robust factor structure among persons with and without objective HIV-associated memory impairment. However, on select PRMQ items, individuals with memory impairment reported observed scores that were relatively higher than their latent score, while items were more strongly associated with the memory factor in a group with greater memory impairment.
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Woods SP, Morgan EE, Loft S, Matchanova A, Verduzco M, Cushman C. Enhancing cue salience improves aspects of naturalistic time-based prospective memory in older adults with HIV disease. Neuropsychology 2021; 35:111-122. [PMID: 33393805 DOI: 10.1037/neu0000644] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
OBJECTIVE Older persons living with HIV (PLWH) disease commonly experience failures of time-based prospective memory (PM) in their daily lives. This study examined the benefits of providing strategic supports at encoding, monitoring, and cue detection for naturalistic time-based PM among older PLWH. METHOD Participants included 116 older PLWH and 48 seronegatives who completed a baseline neuropsychological evaluation (see Woods et al., 2020), including a laboratory PM experiment that paralleled the design of the current naturalistic study. The naturalistic time-based PM task required participants to press a button on a portable PM response box 4 times per day for 1 month. PLWH were randomly assigned to an unsupported control condition or to an experimental group in which strategic processing was supported at encoding (implementation intentions and visualization), monitoring (content-free cuing), and/or cue detection (auditory alarm). The seronegative participants were all assigned to the unsupported control group. RESULTS In a model adjusting for age and affective disorders, PLWH who received all three supports in combination demonstrated moderately better naturalistic time-based PM accuracy as compared with PLWH controls. Both the cue detection and combination conditions were associated with markedly more precise response timing on the naturalistic time-based PM task. Supported PM accuracy as measured in the laboratory was positively associated with naturalistic PM accuracy among PLWH in the experimental groups. CONCLUSIONS Providing strategic supports to enhance the cue salience of naturalistic time-based PM tasks may improve both the accuracy and timing with which older PLWH remember to perform time-based intentions. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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Affiliation(s)
| | - Erin E Morgan
- Department of Psychiatry, University of California, San Diego
| | - Shayne Loft
- School of Psychological Science, University of Western Australia
| | | | | | - Clint Cushman
- Department of Psychiatry, University of California, San Diego
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12
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Henry JD. Prospective memory impairment in neurological disorders: implications and management. Nat Rev Neurol 2021; 17:297-307. [PMID: 33686303 DOI: 10.1038/s41582-021-00472-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/04/2021] [Indexed: 01/31/2023]
Abstract
Prospective memory is a core neurocognitive ability that refers to memory for future intentions, such as remembering to take medications and to switch off appliances. Any breakdown in prospective memory, therefore, has serious implications for the ability to function independently in everyday life. In many neurological disorders, including Parkinson disease and dementia, prospective memory deficits are common even in the earliest stages and typically become more severe with disease progression. Consequently, clinical assessment of prospective memory is of critical importance. This article provides an overview of the various manifestations and neural bases of prospective memory deficits. To facilitate clinical decision-making, validated measures of this construct are identified and their suitability for clinical practice is discussed, focusing in particular on clinical sensitivity and psychometric properties. The article concludes by reviewing the approaches that can be used to rehabilitate different types of prospective memory impairment, and algorithms to guide the evaluation and treatment of these impairments are provided.
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Affiliation(s)
- Julie D Henry
- School of Psychology, The University of Queensland, Brisbane, QLD, Australia.
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13
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Konstantinopoulou E, Ioannidis P, Kiosseoglou G, Aretouli E. Inhibitory control is associated with medication adherence in young HIV patients without comorbidities. APPLIED NEUROPSYCHOLOGY-ADULT 2021; 29:1467-1475. [PMID: 33631076 DOI: 10.1080/23279095.2021.1890594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVE In the present study we evaluated the incremental contribution of executive cognition (EC) subprocesses to antiretroviral medication adherence. METHOD A comprehensive EC test battery assessing updating/working memory, mental flexibility, and inhibitory control, along with measures assessing non-executive cognitive functions were completed by 100 individuals with HIV. Medication adherence was determined via a visual analogue self-report scale and the Medication Adherence Questionnaire. Potential predictors, including demographic and clinical characteristics and neuropsychological performances on EC and other cognitive tasks were regressed to medication adherence. Predictive variables related to executive processes were added in the final block of the hierarchical regression model in order to assess their incremental predictive ability on medication adherence. RESULTS 23% of the variance in the visual analogue scale was explained by treatment complexity, memory and EC performance. A measure of inhibitory control, in particular, predicted self-reported medication adherence above and beyond demographic, clinical and other cognitive factors. CONCLUSIONS The contribution of EC to self-reported medication adherence in young seropositive adults was limited, but inhibitory control was associated with proper medication management above and beyond demographic, clinical and other cognitive functions.
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Affiliation(s)
- Eleni Konstantinopoulou
- Lab of Cognitive Neuroscience, School of Psychology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | - Grigoris Kiosseoglou
- Lab of Cognitive Neuroscience, School of Psychology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Eleni Aretouli
- Lab of Cognitive Neuroscience, School of Psychology, Aristotle University of Thessaloniki, Thessaloniki, Greece.,School of the Social Sciences, University of Ioannina, Ioannina, Greece
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Rivera Mindt M, Arentoft A, Tureson K, Summers AC, Morris EP, Guzman V, Aghvinian MN, Alvarez K, Robbins RN, Savin MJ, Byrd D. Disparities in Electronically Monitored Antiretroviral Adherence and Differential Adherence Predictors in Latinx and Non-Latinx White Persons Living with HIV. AIDS Patient Care STDS 2020; 34:344-355. [PMID: 32757979 PMCID: PMC7415218 DOI: 10.1089/apc.2019.0256] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Antiretroviral therapy (ART) adherence is vital for optimal HIV treatment. However, there is limited ART adherence research on the US Latinx population, who are at increased risk for HIV infection and worse HIV health outcomes. This study examined electronically measured ART adherence (Medication Event Monitoring System) and its association with demographic, clinical, neurocognitive, and sociocultural variables in Latinx and non-Latinx white (NLW) persons living with HIV [PLWH (N = 128)]. Latinx participants demonstrated worse adherence than NLW participants (p = 0.04). Linear regressions revealed different predictors of adherence. Among Latinx participants, recent cocaine use, stress, and, unexpectedly, higher US acculturation predicted worse adherence (ps < 0.05). Among NLW participants, recent cocaine use predicted worse adherence (p < 0.05). Intergroup comparisons within the Latinx group were not conducted due to subsample size. Thus, ethnicity, sociocultural variables, and cocaine use are important considerations for ART adherence, and poor ART adherence may be one pathway explaining worse outcomes in Latinx PLWH. Culturally tailored adherence interventions incorporating substance use treatment, acculturation, and stress management are warranted to improve health outcomes.
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Affiliation(s)
- Monica Rivera Mindt
- Department of Psychology, Fordham University, Bronx, New York, USA
- Department of Neurology and Icahn School of Medicine at Mount Sinai, New York, New York, USA
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Alyssa Arentoft
- Department of Psychology, California State University Northridge, Northridge, California, USA
| | - Kayla Tureson
- Department of Psychology, University of Southern California, Los Angeles, California, USA
| | - Angela C. Summers
- Department of Psychology, Fordham University, Bronx, New York, USA
- Department of Neurology and Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Emily P. Morris
- Department of Psychology, University of Michigan, Ann Arbor, Michigan, USA
| | - Vanessa Guzman
- Department of Psychology, Fordham University, Bronx, New York, USA
- Department of Neurology and Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Maral N. Aghvinian
- Department of Psychology, Fordham University, Bronx, New York, USA
- Department of Neurology and Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Karen Alvarez
- Department of Psychology, California State University Northridge, Northridge, California, USA
| | - Reuben N. Robbins
- Department of Psychiatry, HIV Center for Clinical and Behavioral Studies, Columbia University Vagelos College of Physicians and Surgeons and New York-Presbyterian, New York, New York, USA
| | - Micah J. Savin
- Department of Psychology, Fordham University, Bronx, New York, USA
- Department of Neurology and Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Desiree Byrd
- Department of Neurology and Icahn School of Medicine at Mount Sinai, New York, New York, USA
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York, USA
- Department of Psychology, Queens College, The City University of New York, Queens, New York, USA
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15
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Benzodiazepine Use Is Associated With an Increased Risk of Neurocognitive Impairment in People Living With HIV. J Acquir Immune Defic Syndr 2020; 82:475-482. [PMID: 31714426 DOI: 10.1097/qai.0000000000002183] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECTIVE Despite potential for dependence and adverse neurological effects, long-term benzodiazepine (BZD) use is common among people living with HIV (PLWH). As PLWH are at risk for central nervous system dysfunction, we retrospectively examined the association between BZD use and HIV-associated neurocognitive impairment (NCI). METHODS Three hundred six PLWH underwent comprehensive neurobehavioral evaluations. Current BZD use (BZD+) was determined through self-report. Using propensity scores, 153 BZD- individuals were matched to 153 BZD+ participants on demographics and medical comorbidities. Multiple regression models examined NCI and demographically adjusted neurocognitive T-scores as a function of BZD status, adjusting for estimated premorbid ability, current affective symptoms, and nadir CD4 count. Secondary analyses explored neurocognitive correlates of positive BZD urine toxicology screens (TOX+) and specific BZD agents. RESULTS Median duration of BZD use was 24 months. Current BZD use related to higher likelihood of NCI (odds ratio = 2.13, P = 0.003) and poorer global (d = -0.28, P = 0.020), processing speed (d = -0.23, P = 0.047), and motor T-scores (d = -0.32, P = 0.008). Compared with BZD-/TOX-, BZD+/TOX+ exhibited additional decrements in executive function (d = -0.48, P = 0.013), working memory (d = -0.49, P = 0.011), and delayed recall (d = -0.41, P = 0.032). For individual agents, diazepam, lorazepam, and alprazolam were most strongly associated with NCI (odds ratios >2.31). DISCUSSION BZD use may elevate risk for NCI in PLWH, potentially through diffuse neurocognitive slowing and acute compromise of recall and higher-order capacities. These effects are robust to psychosocial and HIV-specific factors and occur in comparison with a tightly matched BZD- group. Prospective and interventional studies should evaluate causal associations between NCI and BZD use and explore treatment alternatives to BZDs in PLWH.
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16
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Mioni G, Fracasso V, Cardullo S, Stablum F. Comparing different tests to detect early manifestation of prospective memory decline in aging. Clin Neuropsychol 2020; 36:105-137. [PMID: 32301378 DOI: 10.1080/13854046.2020.1749308] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Objective: Prospective memory (PM) is the ability to remember to perform future intentions. Previous studies have demonstrated that, compared to a younger cohort, healthy older adults have impairments in PM. Considering the importance of early detection of age-related PM decline, the present study aims to compare the performance of healthy older adults using three well-known PM tests commonly used in clinical settings.Method: In the present study, we tested 70 older adults (65-95 years old) using the Cambridge Prospective Memory Test (CAMPROMPT), the Memory for Intentions Screening Test (MIST) and the Royal Prince Alfred Prospective Memory Test (RPA-ProMem). In order to compare performance across tests and the interaction between age and cues, we performed a linear mixed model with random intercept and random slopes. Moreover, additional mixed models with random intercept were run for analyzing the additional information provided by MIST and RPA-ProMem regarding delay responses, response modality effects and type of errors committed.Results: Our data showed a drop in PM performance as age increased detected by all three tests. Furthermore, CAMPROMPT was the most sensitive test to identify differences in PM for event-and time-based cues, at least for participants with 65-77 years old. When data were analyzed in term of delay responses, participants were more accurate for 2 min delay (MIST) and 30 in delay (RPA-ProMem). Participants were less accurate when response modality was "verbal" compared to "action" (MIST) and made more PM errors as age increased.Conclusions: Overall, the study provides important information regarding age-related PM decline and can help researchers as well as clinicians in deciding the preferred test to evaluate PM performance.
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Affiliation(s)
- Giovanna Mioni
- Dipartimento di Psicologia Generale, Università di Padova, Padova, Italy
| | - Verena Fracasso
- Dipartimento di Psicologia Generale, Università di Padova, Padova, Italy
| | | | - Franca Stablum
- Dipartimento di Psicologia Generale, Università di Padova, Padova, Italy
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17
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Cooley SA, Paul RH, Ances BM. Medication management abilities are reduced in older persons living with HIV compared with healthy older HIV- controls. J Neurovirol 2020; 26:264-269. [PMID: 31989445 PMCID: PMC7261252 DOI: 10.1007/s13365-020-00827-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2019] [Revised: 12/19/2019] [Accepted: 01/20/2020] [Indexed: 12/22/2022]
Abstract
Although combination antiretroviral therapy (cART) has simplified over the past decade, polypharmacy is increasing for older people living with HIV (PLWH) due to the emergence of multiple health comorbidities. This study examined predictors of, and relationships between, objective (Medication Management Test-Revised (MMT-R)) and self-reported medication management ability in older (≥ 50 years) PLWH (n = 146) compared with HIV-uninfected (HIV-) individuals (n = 60). PLWH scored worse on the MMT-R and had a higher pill burden compared with HIV- individuals. MMT-R failure was predicted by HIV status, race, reading level, and worse executive functioning, as well as history of Hepatitis C and detectable viral load in PLWH. Self-reported ability to manage medications did not relate to MMT-R score. Older PLWH may not self-describe concerns regarding their ability to manage complex medication regimens. Our results emphasize the need for objective measurements of medication management ability.
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Affiliation(s)
- Sarah A Cooley
- Department of Neurology, Washington University School of Medicine in Saint Louis, 660 S Euclid Ave, Campus Box 8111, St. Louis, MO, 63110, USA
| | - Robert H Paul
- Department of Psychological Sciences, University of Missouri-Saint Louis, St. Louis, MO, USA
- Missouri Institute of Mental Health, St. Louis, MO, USA
| | - Beau M Ances
- Department of Neurology, Washington University School of Medicine in Saint Louis, 660 S Euclid Ave, Campus Box 8111, St. Louis, MO, 63110, USA.
- Department of Radiology, Washington University in Saint Louis, St. Louis, MO, USA.
- Department of Biomedical Engineering, Washington University in Saint Louis, St. Louis, MO, USA.
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18
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Sumida CA, Van Etten EJ, Lopez FV, Sheppard DP, Pirogovsky-Turk E, Corey-Bloom J, Filoteo JV, Woods SP, Gilbert PE, Schmitter-Edgecombe M. Medication Management Capacity and Its Neurocognitive Correlates in Huntington's Disease. Arch Clin Neuropsychol 2020; 34:1121-1126. [PMID: 30517595 DOI: 10.1093/arclin/acy093] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2018] [Revised: 10/01/2018] [Accepted: 11/05/2018] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE Although medication management is a necessary daily activity for individuals with Huntington's disease (HD), medication management abilities and their relation to cognitive functioning have not been evaluated. METHOD Twenty individuals with HD and 20 healthy adults (HA) completed the Medication Management Abilities Assessment (MMAA). Individuals with HD also completed a self-report medication management measure and neuropsychological tests assessing executive function, retrospective memory, and prospective memory. RESULTS Individuals with HD performed significantly poorer and made more undertaking errors on the MMAA as compared to HA. No group differences were found in overtaking errors. In the HD group, significant associations were found between undertaking errors and perceived medication management ability as well as between MMAA task performance and measures assessing prospective memory and executive functions. CONCLUSIONS Medication management capacity was negatively affected in individuals with HD and may be associated with difficulty remembering to take medications in the future.
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Affiliation(s)
| | | | - Francesca V Lopez
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
| | - David P Sheppard
- Department of Psychology, University of Houston, Houston, TX, USA
| | - Eva Pirogovsky-Turk
- Department of Psychiatry, University of California San Diego, San Diego, CA, USA
| | - Jody Corey-Bloom
- Department of Neuroscience, University of California San Diego, San Diego, CA, USA
| | - J Vincent Filoteo
- Department of Psychiatry, University of California San Diego, San Diego, CA, USA.,Department of Neuroscience, University of California San Diego, San Diego, CA, USA
| | - Steven P Woods
- Department of Psychology, University of Houston, Houston, TX, USA
| | - Paul E Gilbert
- Department of Psychology, San Diego State University, San Diego, CA, USA
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19
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Suchy Y, Ziemnik RE, Niermeyer MA, Brothers SL. Executive functioning interacts with complexity of daily life in predicting daily medication management among older adults. Clin Neuropsychol 2019; 34:797-825. [DOI: 10.1080/13854046.2019.1694702] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Yana Suchy
- Department of Psychology, University of Utah, Salt Lake City, UT, USA
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20
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Kordovski VM, Sullivan KL, Tierney SM, Woods SP. One-year stability of prospective memory symptoms and performance in aging and HIV disease. J Clin Exp Neuropsychol 2019; 42:118-130. [PMID: 31698985 DOI: 10.1080/13803395.2019.1687651] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Introduction: HIV disease and aging can both affect prospective memory (PM), which describes the complex process of executing delayed intentions and plays an essential role in everyday functioning. The current study investigated the course of PM symptoms and performance over approximately one year in younger and older persons with and without HIV disease. Method: Participants included 77 older (>50 years) and 35 younger (<40 years) HIV+ individuals and 44 older and 27 younger seronegative adults. Participants completed the Memory for Intentions Test to measure PM in the laboratory, the Prospective and Retrospective Memory Questionnaire to measure PM symptoms in daily life, and several clinical measures of executive functions and retrospective memory as a part of a comprehensive neurocognitive evaluation at baseline and at 14-month follow-up. Results: Findings showed additive, independent main effects of HIV and aging on time- and event-based PM performance in the laboratory, but no change in PM over time. There were no interactions between time and HIV or age groups. Parallel findings were observed for clinical measures of retrospective memory and executive functions. Older HIV+ adults endorsed the greatest frequency of PM symptoms, but there was no change in PM symptom severity over time and no interactions between time and HIV or age groups. There were no effects of HIV or aging on naturalistic PM performance longitudinally. Conclusion: Overall these findings suggest that PM symptoms and performance in the laboratory are stably impaired over the course of a year in the setting of aging and HIV disease.
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Affiliation(s)
| | - Kelli L Sullivan
- Department of Psychology, University of Houston, Houston, TX, USA
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21
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Pennar A, Naar S, Woods S, Nichols S, Outlaw A, Ellis D. Promoting resilience through neurocognitive functioning in youth living with HIV. AIDS Care 2019; 30:59-64. [PMID: 30714388 DOI: 10.1080/09540121.2019.1576851] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Using a phased model of intervention development, we developed an intervention to promote resilience in youth living with HIV via improved neurocognitive resources. First, youth completed a naturalistic prospective memory (PM) task and were randomized into a visualization condition or control condition. Next, 47 of these participants completed another naturalistic PM task and were randomized into Calendaring condition, an Alarm condition, a Combined condition, or a Control condition. Youth with low PM demonstrated observable gains from the visualization technique. Youth in the Combined Calendaring and Alarm condition demonstrated significantly better performance than participants in the Control and Calendaring conditions. In a Proof-of-Concept study with 16 youth, the previous findings were translated into a single session in-person intervention followed by tailored text messaging to improve adherence and viral load via improved neurocognitive resources. The resulting intervention showed a signal of effect with viral load reductions in youth with available data. Targeting compensatory strategies to enhance neurocognitive functioning may promote resilience and health outcomes. A randomized pilot study with a control condition is the next step.
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Affiliation(s)
- Amy Pennar
- a Center for Translational Behavioral Science , Florida State University , Tallahassee , FL , USA
| | - Sylvie Naar
- a Center for Translational Behavioral Science , Florida State University , Tallahassee , FL , USA
| | - Steven Woods
- b Department of Psychology , University of Houston , Houston , TX , USA.,c Department of Psychiatry , University of California , San Diego , CA , USA
| | - Sharon Nichols
- d Department of Neurosciences , University of California , San Diego , CA , USA
| | - Angulique Outlaw
- e Department of Family Medicine and Public Health Sciences , Wayne State University , Detroit , MI , USA
| | - Deborah Ellis
- e Department of Family Medicine and Public Health Sciences , Wayne State University , Detroit , MI , USA
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22
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Garvie PA, Nichols SL, Williams PL, Harris LL, Kammerer B, Chernoff MC, Figueroa V, Woods SP. Development and reliability of the Prospective Memory Assessment for Children & Youth (PROMACY): A preliminary study in a nonclinical sample. APPLIED NEUROPSYCHOLOGY-CHILD 2018; 8:333-346. [PMID: 30295555 DOI: 10.1080/21622965.2018.1486194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Prospective memory (PM), "remembering to remember," has been linked to important functional outcomes in adults. Studies of PM in children and adolescents would benefit from the development and validation of developmentally appropriate clinical measures with known psychometric properties. The Prospective Memory Assessment for Children & Youth (PROMACY), a performance-based measure of PM, was developed for the Pediatric HIV/AIDS Cohort Study Adolescent Master Protocol, Memory and Executive Functioning Substudy, and includes Summary, Time-, and Event-based scores derived from eight trials with an ongoing word search task. Fifty-four healthy perinatally HIV-exposed, uninfected children and youth, mean age 13 years, 54% female, 76% Black/non-Hispanic, and 61% impoverished were included in this psychometric analysis. PROMACY Summary Scores demonstrated low, but broadly acceptable internal consistency as measured by Cronbach's alpha and Spearman-Brown. Better PROMACY performance was associated with older age, but no other demographic factors. Generally medium-sized correlations were observed between the PROMACY Summary Score and standard clinical measures of retrospective memory, working memory, executive functions, and IQ. Findings from this preliminary psychometric study of nonclinical children and youth provide cautious support for the internal consistency and construct validity of PROMACY's Summary Score that awaits replication and extension in larger samples of healthy children, youth and clinical populations.
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Affiliation(s)
- Patricia A Garvie
- Research Department, Children's Diagnostic & Treatment Center , Fort Lauderdale , FLorida , USA
| | - Sharon L Nichols
- Department of Neurosciences, University of California , La Jolla , California , USA
| | - Paige L Williams
- Department of Biostatistics, Harvard T. H. Chan School of Public Health , Boston , Massachusetts , USA
| | - Lynnette L Harris
- Department of Pediatrics, Baylor College of Medicine , Houston , Texas , USA
| | - Betsy Kammerer
- Department of Psychiatry, Boston Children's Hospital , Boston , Massachusetts , USA
| | - Miriam C Chernoff
- Center for Biostatistics in AIDS Research, Harvard T.H. Chan School of Public Health , Boston , Massachusetts , USA
| | - Veronica Figueroa
- Department of Pediatrics, Mother-Child-Adolescent HIV Program, University of California San Diego , San Diego, California , USA
| | - Steven Paul Woods
- Department of Psychiatry, University of California , San Diego , California , USA.,Department of Psychology, University of Houston , Houston , Texas , USA
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23
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Pennar A, Naar S, Woods S, Nichols S, Outlaw A, Ellis D. Promoting resilience through neurocognitive functioning in youth living with HIV. AIDS Care 2018. [DOI: https:/doi:10.1080/09540121.2019.1576851] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Affiliation(s)
- Amy Pennar
- Center for Translational Behavioral Science, Florida State University, Tallahassee, FL, USA
| | - Sylvie Naar
- Center for Translational Behavioral Science, Florida State University, Tallahassee, FL, USA
| | - Steven Woods
- Department of Psychology, University of Houston, Houston, TX, USA
- Department of Psychiatry, University of California, San Diego, CA, USA
| | - Sharon Nichols
- Department of Neurosciences, University of California, San Diego, CA, USA
| | - Angulique Outlaw
- Department of Family Medicine and Public Health Sciences, Wayne State University, Detroit, MI, USA
| | - Deborah Ellis
- Department of Family Medicine and Public Health Sciences, Wayne State University, Detroit, MI, USA
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24
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Wong A, Fong CH, Mok VCT, Leung KT, Tong RKY. Computerized Cognitive Screen (CoCoSc): A Self-Administered Computerized Test for Screening for Cognitive Impairment in Community Social Centers. J Alzheimers Dis 2018; 59:1299-1306. [PMID: 28731437 DOI: 10.3233/jad-170196] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Computerized cognitive tests may serve as a preliminary, low-cost method to identify individuals with suspected cognitive impairment in the community. OBJECTIVE To develop a self-administered computerized test, namely the "Computerized Cognitive Screen (CoCoSc), Hong Kong version", for screening of individuals with cognitive impairment (CI) in community settings. METHODS The CoCoSc is a 15-min computerized cognitive screen covering memory, executive functions, orientation, attention and working memory, and prospective memory administered on a touchscreen computer. Individuals with CI and cognitively normal controls were administered the CoCoSc and the Montreal Cognitive Assessment (MoCA). Validity of the CoCoSc was assessed based on the relationship with the MoCA using Pearson correlation. Receiver operating characteristic curve (ROC) was used to examine the ability of the CoCoSc to differentiate CI from controls. RESULTS Fifty-nine individuals with CI and 101 controls were recruited. Seventy-five (46.9%) participants had ≤6 years of education. Performance on the CoCoSc differed between normal and CI groups in both low and high education subgroups. Total scores of the CoCoSc and MoCA were significantly correlated (r = 0.71, p < 0.001). The area under ROC was 0.78, p < 0.001 for the CoCoSc total score in differentiating the CI group from the cognitively normal group. A cut-off of ≤30 on the CoCoSc was associated with a sensitivity of 0.78 and specificity of 0.69. The CoCoSc was well accepted by attendees of community social centers. CONCLUSION The CoCoSc is a promising computerized cognitive screen for self-administration in community social centers. It is feasible for testing individuals with high or low education levels.
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Affiliation(s)
- Adrian Wong
- Department of Medicine and Therapeutics, Lui Che Woo Institute of Innovative Medicine, Hong Kong, China.,Therese Pei Fong Chow Research Center for Prevention of Dementia, The Chinese University of Hong Kong, Hong Kong, China
| | - Ching-Hang Fong
- Cognix Limited, Pak Shek Kok, Hong Kong and Former Research Fellow at the Hong Kong Polytechnic University, Hong Kong, China
| | - Vincent Chung-Tong Mok
- Department of Medicine and Therapeutics, Lui Che Woo Institute of Innovative Medicine, Hong Kong, China.,Therese Pei Fong Chow Research Center for Prevention of Dementia, The Chinese University of Hong Kong, Hong Kong, China.,Chow Yuk Ho Technology Center for Innovative Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Kam-Tat Leung
- Department of Medicine and Therapeutics, Lui Che Woo Institute of Innovative Medicine, Hong Kong, China
| | - Raymond Kai-Yu Tong
- Department of Biomedical Engineering, The Chinese University of Hong Kong, Hong Kong, China
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25
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Babiloni C, Noce G, Pennica A, Onorati P, Capotosto P, Del Percio C, Roma P, Correr V, Piccinni E, Toma G, Soricelli A, Di Campli F, Gianserra L, Ciullini L, Aceti A, Teti E, Sarmati L, Crocetti G, Ferri R, Catania V, Pascarelli MT, Andreoni M, Ferracuti S. Cortical sources of resting state electroencephalographic rhythms probe brain function in naïve HIV individuals. Clin Neurophysiol 2017; 129:431-441. [PMID: 29304418 DOI: 10.1016/j.clinph.2017.12.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2016] [Revised: 10/31/2017] [Accepted: 12/05/2017] [Indexed: 10/18/2022]
Abstract
OBJECTIVE Here we evaluated the hypothesis that resting state electroencephalographic (EEG) cortical sources correlated with cognitive functions and discriminated asymptomatic treatment-naïve HIV subjects (no AIDS). METHODS EEG, clinical, and neuropsychological data were collected in 103 treatment-naïve HIV subjects (88 males; mean age 39.8 years ± 1.1 standard error of the mean, SE). An age-matched group of 70 cognitively normal and HIV-negative (Healthy; 56 males; 39.0 years ± 2.0 SE) subjects, selected from a local university archive, was used for control purposes. LORETA freeware was used for EEG source estimation in fronto-central, temporal, and parieto-occipital regions of interest. RESULTS Widespread sources of delta (<4 Hz) and alpha (8-12 Hz) rhythms were abnormal in the treatment-naïve HIV group. Fronto-central delta source activity showed a slight but significant (p < 0.05, corrected) negative correlation with verbal and semantic test scores. So did parieto-occipital delta/alpha source ratio with memory and composite cognitive scores. These sources allowed a moderate classification accuracy between HIV and control individuals (area under the ROC curves of 70-75%). CONCLUSIONS Regional EEG abnormalities in quiet wakefulness characterized treatment-naïve HIV subjects at the individual level. SIGNIFICANCE This EEG approach may contribute to the management of treatment-naïve HIV subjects at risk of cognitive deficits.
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Affiliation(s)
- Claudio Babiloni
- Department of Physiology and Pharmacology, University of Rome "La Sapienza", Rome, Italy; Institute for Research and Medical Care, IRCCS San Raffaele Pisana, Rome, Italy.
| | - Giuseppe Noce
- Department of Integrated Imaging, IRCCS SDN, Naples, Italy
| | - Alfredo Pennica
- Infectious Diseases, Faculty of Medicine and Psychology, University of Rome "La Sapienza", Rome, Italy
| | - Paolo Onorati
- Department of Physiology and Pharmacology, University of Rome "La Sapienza", Rome, Italy; Institute for Research and Medical Care, IRCCS San Raffaele Pisana, Rome, Italy
| | - Paolo Capotosto
- Department of Neuroscience, Imaging and Clinical Sciences, and ITAB-Institute of Advanced Biomedical Technologies "G. d'Annunzio" University of Chieti and Pescara, Chieti, Italy
| | | | - Paolo Roma
- Department of Neurology and Psychiatry, University of Rome "La Sapienza", Rome, Italy
| | - Valentina Correr
- Department of Neurology and Psychiatry, University of Rome "La Sapienza", Rome, Italy
| | - Elisa Piccinni
- Department of Neurology and Psychiatry, University of Rome "La Sapienza", Rome, Italy
| | - Ginevra Toma
- Department of Physiology and Pharmacology, University of Rome "La Sapienza", Rome, Italy
| | - Andrea Soricelli
- Department of Integrated Imaging, IRCCS SDN, Naples, Italy; Department of Motor Sciences and Healthiness, University of Naples Parthenope, Naples, Italy
| | - Francesco Di Campli
- Infectious Diseases, Faculty of Medicine and Psychology, University of Rome "La Sapienza", Rome, Italy
| | - Laura Gianserra
- Infectious Diseases, Faculty of Medicine and Psychology, University of Rome "La Sapienza", Rome, Italy
| | - Lorenzo Ciullini
- Infectious Diseases, Faculty of Medicine and Psychology, University of Rome "La Sapienza", Rome, Italy
| | - Antonio Aceti
- Infectious Diseases, Faculty of Medicine and Psychology, University of Rome "La Sapienza", Rome, Italy
| | - Elisabetta Teti
- Clinical Infectious Diseases, University of Rome "Tor Vergata", Rome, Italy
| | - Loredana Sarmati
- Clinical Infectious Diseases, University of Rome "Tor Vergata", Rome, Italy
| | - Gloria Crocetti
- Infectious Diseases, Faculty of Medicine and Psychology, University of Rome "La Sapienza", Rome, Italy
| | - Raffaele Ferri
- Department of Neurology, IRCCS Oasi Institute for Research on Mental Retardation and Brain Aging, Troina, Enna, Italy
| | - Valentina Catania
- Department of Neurology, IRCCS Oasi Institute for Research on Mental Retardation and Brain Aging, Troina, Enna, Italy
| | - Maria Teresa Pascarelli
- Department of Neurology, IRCCS Oasi Institute for Research on Mental Retardation and Brain Aging, Troina, Enna, Italy
| | - Massimo Andreoni
- Clinical Infectious Diseases, University of Rome "Tor Vergata", Rome, Italy
| | - Stefano Ferracuti
- Department of Neurology and Psychiatry, University of Rome "La Sapienza", Rome, Italy
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Gatzounis R, Schrooten MGS, Crombez G, Vlaeyen JWS. Forgetting to remember? Prospective memory within the context of pain. Eur J Pain 2017; 22:614-625. [PMID: 29226495 DOI: 10.1002/ejp.1152] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/23/2017] [Indexed: 11/06/2022]
Abstract
BACKGROUND Pain interferes with cognitive functioning in several ways. Among other symptoms, pain patients often report difficulties with remembering future intentions. It remains unclear, however, whether it is the pain per se that impairs prospective remembering or other factors that often characterize people with pain (e.g. poor sleep quality). In this experiment, we investigated whether prospective memory is impaired within the context of pain, and whether this impairment is enhanced when the threat value of pain is increased. METHODS Healthy participants engaged in an ongoing word categorization task, during which they received either experimental pain stimuli (with or without threatening instructions designed to increase the threat value of pain), or no pain stimuli (no somatic stimuli and no threatening instructions). Crucially, participants were also instructed to perform a prospective memory intention on future moments that would be signalled by specific retrieval cues. RESULTS Threatening instructions did not differentiate the pain groups in terms of pain threat value; therefore, we only focus on the difference between pain and no pain. Pain and no-pain groups performed the prospective memory intention with similar frequency, indicating that prospective memory is not necessarily impaired when the intended action has to be performed in a painful context. CONCLUSIONS Findings are discussed in the framework of the multiprocess theory of prospective memory, which differentiates between the spontaneous and the strategic retrieval of intentions. Methodological considerations and suggestions for future research are discussed. SIGNIFICANCE This laboratory study combines established methods from two research fields to investigate the effects of a painful context on memory for future intentions. Painful context did not impair performance of a prospective memory intention that is assumed to be retrieved by means of spontaneous processing.
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Affiliation(s)
- R Gatzounis
- Research Group Health Psychology, Faculty of Psychology and Educational Sciences, University of Leuven, Belgium.,Section Behavioral Medicine, Department of Clinical Psychological Science, Maastricht University, The Netherlands
| | - M G S Schrooten
- Research Group Health Psychology, Faculty of Psychology and Educational Sciences, University of Leuven, Belgium.,Centre for Health and Medical Psychology, School of Law, Psychology and Social Work, Örebro University, Sweden
| | - G Crombez
- Department of Experimental-Clinical and Health Psychology, Faculty of Psychology and Educational Sciences, Ghent University, Belgium
| | - J W S Vlaeyen
- Research Group Health Psychology, Faculty of Psychology and Educational Sciences, University of Leuven, Belgium.,Section Behavioral Medicine, Department of Clinical Psychological Science, Maastricht University, The Netherlands
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Wang Y, Chan RCK, Shum DHK. Schizophrenia and prospective memory impairments: a review. Clin Neuropsychol 2017; 32:836-857. [DOI: 10.1080/13854046.2017.1406144] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
- Ya Wang
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Raymond C. K. Chan
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - David H. K. Shum
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Beijing, China
- School of Applied Psychology, Griffith University, Gold Coast, Australia
- Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia
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Avci G, Sheppard DP, Tierney SM, Kordovski VM, Sullivan KL, Woods SP. A systematic review of prospective memory in HIV disease: from the laboratory to daily life. Clin Neuropsychol 2017; 32:858-890. [PMID: 28950745 DOI: 10.1080/13854046.2017.1373860] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE Prospective memory (PM) is described as the capacity to form and maintain an intention that is executed in response to a specific cue. Neural injury and associated neurocognitive disorders are common among persons living with HIV disease, who might therefore be susceptible to impairment in PM. METHOD This literature review utilized a structured qualitative approach to summarize and evaluate our current understanding of PM functioning in people living with HIV disease. 33 studies of PM in HIV+ persons met criteria for inclusion. RESULTS Findings showed that HIV is associated with moderate deficits in PM, which appear to be largely independent of commonly observed comorbid factors. The pattern of PM deficits reveals dysregulation of strategic processes that is consistent with the frontal systems pathology and associated executive dysfunction that characterizes HIV-associated neural injury. The literature also suggests that HIV-associated PM deficits present a strong risk of concurrent problems in a wide range of health behaviors (e.g. medication non-adherence) and activities of daily living (e.g. employment). Early attempts to improve PM in HIV disease have revealed that supporting strategic processes might be effective for some individuals. CONCLUSIONS HIV-associated PM deficits are common and exert a significant adverse effect on the daily lives and health of infected persons. Much work remains to be done to understand the cognitive architecture of HIV-associated PM deficits and the most efficient means to enhance PM functioning and improve health outcomes in persons living with HIV.
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Affiliation(s)
- Gunes Avci
- a Department of Psychology , University of Houston , Houston , TX , USA
| | - David P Sheppard
- a Department of Psychology , University of Houston , Houston , TX , USA
| | - Savanna M Tierney
- a Department of Psychology , University of Houston , Houston , TX , USA
| | | | - Kelli L Sullivan
- a Department of Psychology , University of Houston , Houston , TX , USA
| | - Steven Paul Woods
- a Department of Psychology , University of Houston , Houston , TX , USA
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Harris LL, Chernoff MC, Nichols SL, Williams PL, Garvie PA, Yildirim C, McCauley SR, Woods SP. Prospective memory in youth with perinatally-acquired HIV infection. Child Neuropsychol 2017; 24:938-958. [PMID: 28782457 DOI: 10.1080/09297049.2017.1360854] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Youth with perinatal HIV infection (PHIV) are at increased risk for neurocognitive impairment (NCI). Prospective memory (PM) is a complex neurocognitive function that has been shown to be impaired in adults with HIV disease and independently associated with poorer daily living skills, including medication nonadherence. The current study sought to determine the presence and extent of PM deficits in youth with PHIV. Participants included 173 youth with PHIV and 85 youth perinatally HIV-exposed but uninfected (PHEU), mean age 14.1 years, 75% black, 18% Hispanic. Among youth with PHIV, 26% had a past AIDS-defining condition (Centers for Disease Control and Prevention [CDC], Class C), 74% did not (non-C). Adjusted generalized estimating equation models were used to compare groups (PHIV/C, PHIV/non-C, and PHEU) on the Naturalistic Event-Based Prospective Memory Test (NEPT) and the Prospective Memory Assessment for Children & Youth (PROMACY). Secondarily, subgroups defined by HIV serostatus and global NCI were compared (PHIV/NCI, PHIV/non-NCI, PHEU). PHIV/C had significantly lower NEPT scores than PHEU, with decreases of 40% in mean scores, but did not differ from PHIV/non-C. PHIV/NCI had 11-32% lower PROMACY scores and 33% lower NEPT scores compared to PHIV/non-NCI (all p < .05); significantly, lower scores for PHIV/NCI versus PHEU also were observed for PROMACY and NEPT indices. Findings suggest a subset of youth with PHIV (those with a prior AIDS-defining diagnosis) is vulnerable to PM deficits. The extent to which PM deficits interfere with development and maintenance of independent living and health-related behaviors during transition to adulthood requires further study.
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Affiliation(s)
- Lynnette L Harris
- a Department of Pediatrics , Baylor College of Medicine , Houston , TX , USA
| | - Miriam C Chernoff
- b Center for Biostatistics in AIDS Research , Harvard T.H. Chan School of Public Health , Boston , MA , USA
| | - Sharon L Nichols
- c Department of Neurosciences , University of California , San Diego , CA , USA
| | - Paige L Williams
- d Center for Biostatistics in AIDS Research & Department of Biostatistics , Harvard T.H. Chan School of Public Health , Boston , MA , USA
| | - Patricia A Garvie
- e Research Department , Children's Diagnostic & Treatment Center , Fort Lauderdale , FL , USA
| | - Cenk Yildirim
- b Center for Biostatistics in AIDS Research , Harvard T.H. Chan School of Public Health , Boston , MA , USA
| | - Stephen R McCauley
- f Departments of Physical Medicine & Rehabilitation, Neurology, and Pediatrics, Baylor College of Medicine , Michael E. DeBakey VA Medical Center , Houston , TX , USA
| | - Steven Paul Woods
- c Department of Neurosciences , University of California , San Diego , CA , USA.,g Department of Psychology , University of Houston , Houston , TX , USA
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Keutmann MK, Gonzalez R, Maki PM, Rubin LH, Vassileva J, Martin EM. Sex differences in HIV effects on visual memory among substance-dependent individuals. J Clin Exp Neuropsychol 2017; 39:574-586. [PMID: 27841082 PMCID: PMC5395326 DOI: 10.1080/13803395.2016.1250869] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
HIV's effects on episodic memory have not been compared systematically between male and female substance-dependent individuals. We administered the Brief Visuospatial Memory Test-Revised (BVMT-R) to 280 substance-dependent HIV+ and HIV- men and women. Groups were comparable on demographic, substance use, and comorbid characteristics. There were no significant main effects of sex or HIV serostatus on BVMT-R performance, but HIV+ women performed significantly more poorly on delayed recall. This effect was most prominent among cocaine-dependent HIV+ women. Our findings are consistent with recent speculation that memory impairment may be more common among HIV+ women, particularly those with a history of cocaine dependence.
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Affiliation(s)
| | - Raul Gonzalez
- Department of Psychology, Florida International University, Miami, FL, USA
| | - Pauline M. Maki
- Department of Psychiatry, University of Illinois, Chicago, IL, USA
| | - Leah H. Rubin
- Department of Psychiatry, University of Illinois, Chicago, IL, USA
| | - Jasmin Vassileva
- Department of Psychiatry, Virginia Commonwealth University, Richmond, VA, USA
| | - Eileen M. Martin
- Department of Psychiatry, Rush University Medical Center, Chicago, IL, USA
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Zamroziewicz M, Raskin SA, Tennen H, Austad CS, Wood RM, Fallahi CR, Dager AD, Sawyer B, Leen S, Pearlson GD. Effects of drinking patterns on prospective memory performance in college students. Neuropsychology 2017; 31:191-199. [PMID: 27841457 PMCID: PMC5280574 DOI: 10.1037/neu0000313] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
OBJECTIVE Traditional college students are at a critical juncture in the development of prospective memory (PM). Their brains are vulnerable to the effects of alcohol. METHOD There were 123 third and fourth year college students, 19-23 years old, who completed the Self-Rating Effects of Alcohol (SREA), Modified Timeline Follow-back (TFLB), Brief Young Adult Alcohol Consequences Scale (BYAACS), and Alcohol Effects Questionnaire (AEQ) once per month on a secure online database, as reported elsewhere (Dager et al., 2013). Data from the 6 months immediately before memory testing were averaged. In a single testing session participants were administered the Mini International Neuropsychiatric Interview-Diagnostic and Statistical Manual for Mental Disorders-Fourth Edition-Text Revision (MINI-DSM-IV-TR), measures of PM (event-based and time-based), and retrospective memory (RM). Based on the average score of six consecutive monthly responses to the SREA, TLFB, and AEQ, students were classified as nondrinkers, light drinkers, or heavy drinkers (as defined previously; Dager et al., 2013). Alcohol-induced amnesia (blackout) was measured with the BYAACS. RESULTS We found a relationship between these alcohol use classifications and time-based PM, such that participants who were classified as heavier drinkers were more likely to forget to perform the time-based PM task. We also found that self-reported alcohol-induced amnesia (blackouts) during the month immediately preceding memory testing was associated with lower performance on the event-based PM task. Participants' ability to recall the RM tasks suggested the PM items were successfully encoded even when they were not carried out, and we observed no relationship between alcohol use and RM performance. CONCLUSION Heavy alcohol use in college students may be related to impairments in PM. (PsycINFO Database Record
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Affiliation(s)
| | | | - Howard Tennen
- Department of Community Medicine and Health Care, University of Connecticut School of Medicine
| | - Carol S Austad
- Department of Psychology, Central Connecticut State University
| | - Rebecca M Wood
- Department of Psychology, Central Connecticut State University
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Sirois PA, Chernoff MC, Malee KM, Garvie PA, Harris LL, Williams PL, Woods SP, Nozyce ML, Kammerer BL, Yildirim C, Nichols SL. Associations of Memory and Executive Functioning With Academic and Adaptive Functioning Among Youth With Perinatal HIV Exposure and/or Infection. J Pediatric Infect Dis Soc 2016; 5:S24-S32. [PMID: 27856673 PMCID: PMC5181543 DOI: 10.1093/jpids/piw046] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2016] [Accepted: 07/11/2016] [Indexed: 11/13/2022]
Abstract
BACKGROUND Perinatally acquired HIV (PHIV) confers risk for neurocognitive impairment, which potentially affects school performance and functional independence of infected children. In this study, we examined the associations of 2 key neurocognitive domains, memory and executive function (EF), with academic and adaptive skills among youth with PHIV and perinatally HIV-exposed but uninfected (PHEU) youth. METHODS Participants ages 9 to <19 years enrolled in the Pediatric HIV/AIDS Cohort Study's Memory and Executive Functioning Study completed standardized measures of reading and math. The primary caregivers completed a standardized measure of their child's adaptive behavior. Participants with PHIV, those with (PHIV/C) and without (PHIV/non-C) a Centers for Disease Control and Prevention class C diagnosis, and PHEU participants were compared. Retrospective memory (RM), prospective memory (PM), and EF were evaluated relative to outcomes using general linear regression models adjusted for sociodemographic characteristics. RESULTS Of the participants (N = 258; mean age, 14.1 years), 46% were male, 75% were black, and 18% were Hispanic. Adjusted mean scores in math and adaptive behavior did not differ among the youth with PHIV/C (n = 45), those with PHIV/non-C (n = 128), and PHEU youth (n = 85). Youth with PHIV/C had lower adjusted mean reading scores than PHIV/non-C and PHEU youth (86.9 vs 93.8 [P = .02] and 93.2 [P = .04], respectively). There were positive associations of RM, PM, EF, and some sociodemographic characteristics with higher reading and math scores. Immediate and delayed verbal memory, delayed visual memory, PM, and some EF measures were positively associated with adaptive behavior. CONCLUSIONS Higher-order cognitive abilities such as memory and EF seem to play a key role in academic and adaptive capacities, regardless of a child's HIV status, and might serve as intervention targets for improving functional outcomes.
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Affiliation(s)
- Patricia A. Sirois
- Department of Pediatrics, Tulane University School of Medicine, New Orleans, Louisiana
| | - Miriam C. Chernoff
- Center for Biostatistics in AIDS Research, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
| | - Kathleen M. Malee
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Patricia A. Garvie
- Research Department, Children's Diagnostic & Treatment Center, Fort Lauderdale, Florida
| | | | - Paige L. Williams
- Center for Biostatistics in AIDS Research, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
| | | | - Molly L. Nozyce
- Department of Pediatrics, Jacobi Medical Center, Albert Einstein College of Medicine, Bronx, New York
| | | | - Cenk Yildirim
- Center for Biostatistics in AIDS Research, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
| | - Sharon L. Nichols
- Department of Neurosciences, University of California, San Diego, La Jolla
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Arentsen TJ, Panos S, Thames AD, Arbid JN, Castellon SA, Hinkin CH. Psychosocial Correlates of Medication Adherence among HIV-Positive, Cognitively Impaired Individuals. JOURNAL OF HIV/AIDS & SOCIAL SERVICES 2016; 15:404-416. [PMID: 28713226 PMCID: PMC5509354 DOI: 10.1080/15381501.2016.1228309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Although cognitive impairment has been shown to adversely affect antiviral medication adherence, a subset of cognitively impaired adults nonetheless are able to adequately adhere to their medication regimen. However, little is known about factors that serve as buffers against suboptimal adherence among the cognitively impaired. This study consisted of 160 HIV-positive, cognitively impaired adults (Global Deficit Score ≥ 0.50) whose medication adherence was monitored over 6-months using an electronic monitoring device (MEMS caps). Logistic regressions were run to determine psychosocial variables associated with medication adherence. Higher self-efficacy and treatment related support, a stable medication regimen, stable stress levels, and absence of current stimulant use were predictive of optimal adherence. A distinct array of psychosocial factors was found that buffer against the adverse effects of cognitive impairment on medication adherence. Assessment and interventions targeting these factors may improve adherence rates among cognitively impaired adults.
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Affiliation(s)
| | - Stella Panos
- VA Greater Los Angeles Healthcare System, Los Angeles CA
- University of California, Los Angeles, Psychiatry and Biobehavioral Sciences, Los Angeles CA
| | - April D. Thames
- University of California, Los Angeles, Psychiatry and Biobehavioral Sciences, Los Angeles CA
| | | | - Steven A. Castellon
- VA Greater Los Angeles Healthcare System, Los Angeles CA
- University of California, Los Angeles, Psychiatry and Biobehavioral Sciences, Los Angeles CA
| | - Charles H. Hinkin
- VA Greater Los Angeles Healthcare System, Los Angeles CA
- University of California, Los Angeles, Psychiatry and Biobehavioral Sciences, Los Angeles CA
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Sheppard DP, Weber E, Casaletto KB, Avci G, Woods SP. Pill Burden Influences the Association Between Time-Based Prospective Memory and Antiretroviral Therapy Adherence in Younger But Not Older HIV-Infected Adults. J Assoc Nurses AIDS Care 2016; 27:595-607. [PMID: 27160771 DOI: 10.1016/j.jana.2016.03.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2015] [Accepted: 03/29/2016] [Indexed: 11/15/2022]
Abstract
Prospective memory (PM) is associated with antiretroviral (ARV) adherence in HIV, but little is known about how pill burden and age might affect this association. One hundred seventeen older (≥50 years) and 82 younger (<50 years) HIV-infected adults were administered a measure of PM in the laboratory and subsequently were monitored for ARV adherence for 30 days using the Medication Event Monitoring System. In the older group, better time-based PM performance was associated with higher likelihood of adherence, irrespective of pill burden. Within the younger sample, time-based PM was positively related to adherence only in participants with lower pill burdens. Younger HIV-infected individuals with higher pill burdens may overcome the normal effects of time-based PM on adherence through compensatory medication-taking strategies, whereas suboptimal use of these strategies by younger HIV-infected individuals with lower pill burdens may heighten their risk of ARV nonadherence secondary to deficits in time-based PM.
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Avci G, Loft S, Sheppard DP, Woods SP. The effects of HIV disease and older age on laboratory-based, naturalistic, and self-perceived symptoms of prospective memory: does retrieval cue type and delay interval matter? AGING NEUROPSYCHOLOGY AND COGNITION 2016; 23:716-43. [PMID: 27002287 DOI: 10.1080/13825585.2016.1161001] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
There is a rising prevalence of older HIV+ adults who are at risk of deficits in higher order neurocognitive functions and associated problems in everyday functioning. The current study applied multiprocess theory to examine the effects of HIV and aging on measures of laboratory-based, naturalistic, and self-perceived symptoms of prospective memory (PM). Participants included 125 Younger (48 with HIV, age = 32 ± 4.6 years) and 189 Older (112 with HIV, age = 56 ± 4.9 years) adults. Controlling for global neurocognitive functioning, mood, and other demographics, older age and HIV had independent effects on long-delay time-based PM in the laboratory, whereas on a naturalistic PM task older HIV- adults performed better than older HIV+ adults and younger persons. In line with the naturalistic findings, older age, but not HIV, was associated with a relative sparing of self-perceived PM failures in daily life across longer delay self-cued intervals. Findings suggest that, even in relatively younger aging cohorts, the effects of HIV and older age on PM can vary across PM delay intervals by the strategic demands of the retrieval cue type, are expressed differently in the laboratory and in daily life, and are independent of other higher order neurocognitive functions (e.g., retrospective memory).
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Affiliation(s)
- G Avci
- a Department of Psychology , University of Houston , Houston , TX , USA
| | - S Loft
- b School of Psychology , University of Western Australia , Perth , Australia
| | - D P Sheppard
- a Department of Psychology , University of Houston , Houston , TX , USA
| | - S P Woods
- a Department of Psychology , University of Houston , Houston , TX , USA.,b School of Psychology , University of Western Australia , Perth , Australia
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Woods SP, Weinborn M, Li YR, Hodgson E, Ng ARJ, Bucks RS. Does prospective memory influence quality of life in community-dwelling older adults? AGING NEUROPSYCHOLOGY AND COGNITION 2015; 22:679-92. [PMID: 25808599 DOI: 10.1080/13825585.2015.1027651] [Citation(s) in RCA: 57] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Older adults commonly experience declines in prospective memory, which describes one's ability to "remember to remember," and can adversely affect instrumental activities of daily living and healthcare compliance. However, the extent to which prospective memory failures may influence quality of life in typically aging older adults is not well understood. One-hundred and four community-dwelling older Australians (aged 50 to 82 years) were administered a comprehensive, neuropsychological battery that included the Memory for Intentions Screening Test (MIST), Prospective and Retrospective Memory Questionnaire (PRMQ), Instrumental Activities of Daily Living Questionnaire (IADLQ), and World Health Organization Quality of Life-8 (WHOQOL-8). Multiple regressions controlling for negative affect, medical comorbidities, and other neurocognitive functions revealed an interaction between prospective memory and instrumental activities of daily living in the concurrent prediction of quality of life. Among the 39 older adults who reported multiple problems on the IADLQ, lower performance-based prospective memory (MIST) and higher self-reported prospective memory failures in daily life (PRMQ) were significantly associated with lower quality of life (WHOQOL-8). Conversely, no significant associations were observed between prospective memory and quality of life in the 65 participants without IADL problems. Prospective memory difficulties adversely impact quality of life in community-dwelling older adults who experience problems independently managing their instrumental activities of daily living. These findings extend prior literature showing that prospective memory plays a unique role in the real-world outcomes of older adults and clinical populations and highlight the need to develop effective strategies to enhance prospective memory functioning in these vulnerable groups.
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Affiliation(s)
- Steven Paul Woods
- a Department of Psychiatry , University of California-San Diego , La Jolla , CA , USA
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Thaler NS, Sayegh P, Kim MS, Castellon SA, Hinkin CH. Interactive effects of neurocognitive impairment and substance use on antiretroviral non-adherence in HIV disease. Arch Clin Neuropsychol 2015; 30:114-21. [PMID: 25589442 DOI: 10.1093/arclin/acu092] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
While numerous studies have established the adverse independent effects of clinical conditions including neurocognitive dysfunction, psychiatric illness, and substance abuse/dependence on medication adherence among HIV-infected adults, fewer have studied their interactive effects. The current study examined this issue among 204 HIV-infected participants based upon current neurocognitive functioning and DSM-IV-diagnosed psychiatric illness and current substance abuse or dependence. Results confirmed that participants with any of these risk factors demonstrated poorer adherence than individuals with no risk factors. A neurocognitive status × substance abuse/dependence interaction was also identified such that participants with impaired neurocognition and a co-occurring substance abuse/dependence diagnosis demonstrated the poorest adherence. Results confirm the deleterious impact of these risk factors in isolation and also identify a specific interactive effect for individuals with comorbid neurocognitive impairment and a substance abuse/dependence disorder. Findings highlight the need for interventions that simultaneously address these problems.
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Affiliation(s)
- Nicholas S Thaler
- Department of Psychiatry and Biobehavioral Sciences, UCLA Geffen School of Medicine, Los Angeles, CA, USA
| | - Philip Sayegh
- Department of Psychiatry and Biobehavioral Sciences, UCLA Geffen School of Medicine, Los Angeles, CA, USA
| | - Michelle S Kim
- Department of Neurology, University of Washington, Seattle, WA, USA
| | - Steven A Castellon
- Department of Psychiatry and Biobehavioral Sciences, UCLA Geffen School of Medicine, Los Angeles, CA, USA Department of Psychology, VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA
| | - Charles H Hinkin
- Department of Psychiatry and Biobehavioral Sciences, UCLA Geffen School of Medicine, Los Angeles, CA, USA Department of Psychology, VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA
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Morgan EE, Iudicello JE, Cattie JE, Blackstone K, Grant I, Woods SP. Neurocognitive impairment is associated with lower health literacy among persons living with HIV infection. AIDS Behav 2015; 19:166-77. [PMID: 25008384 DOI: 10.1007/s10461-014-0851-7] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
This study sought to determine the effects of HIV-associated neurocognitive disorders (HAND) on health literacy, which encompasses the ability to access, understand, appraise, and apply health-related information. Participants included 56 HIV seropositive individuals, 24 of whom met Frascati criteria for HAND, and 24 seronegative subjects who were comparable on age, education, ethnicity, and oral word reading. Each participant was administered a brief battery of well-validated measures of health literacy, including the Expanded Numeracy Scale (ENS), Newest Vital Sign (NVS), Rapid Estimate of Adult Literacy in Medicine (REALM), and Brief Health Literacy Screen (BHLS). Results revealed significant omnibus differences on the ENS and NVS, which were driven by poorer performance in the HAND group. There were no significant differences on the REALM or the BHLS by HAND status. Among individuals with HAND, lower scores on the NVS were associated with greater severity of neurocognitive dysfunction (e.g., working memory and verbal fluency) and self-reported dependence in activities of daily living. These preliminary findings suggest that HAND hinders both fundamental (i.e., basic knowledge, such as numeracy) and critical (i.e., comprehension and application of healthcare information) health literacy capacities, and therefore may be an important factor in the prevalence of health illiteracy. Health literacy-focused intervention may play an important role in the treatment and health trajectories among persons living with HIV infection.
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Affiliation(s)
- Erin E Morgan
- Department of Psychiatry (8231), University of California, San Diego, 220 Dickinson St., Suite B, San Diego, CA, 92103, USA
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Crystal JD, Wilson AG. Prospective memory: a comparative perspective. Behav Processes 2014; 112:88-99. [PMID: 25101562 DOI: 10.1016/j.beproc.2014.07.016] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2014] [Revised: 07/11/2014] [Accepted: 07/26/2014] [Indexed: 10/24/2022]
Abstract
Prospective memory consists of forming a representation of a future action, temporarily storing that representation in memory, and retrieving it at a future time point. Here, we review the recent development of animal models of prospective memory. We review experiments using rats that focus on the development of time-based and event-based prospective memory. Next, we review a number of prospective-memory approaches that have been used with a variety of non-human primates. Finally, we review selected approaches from the human literature on prospective memory to identify targets for development of animal models of prospective memory. This article is part of a Special Issue entitled: "Tribute to Tom Zentall".
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Affiliation(s)
- Jonathon D Crystal
- Department of Psychological & Brain Sciences, Indiana University, United States.
| | - A George Wilson
- Virginia Tech Carilion School of Medicine and Research Institute, United States
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Coulehan K, Byrd D, Arentoft A, Monzones J, Fuentes A, Fraser F, Rosario A, Morgello S, Mindt MR. The role of decision-making ability in HIV/AIDS: impact on prospective memory. J Clin Exp Neuropsychol 2014; 36:730-41. [PMID: 25089330 DOI: 10.1080/13803395.2014.935705] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
BACKGROUND Prospective memory (ProM), a form of episodic memory related to execution of future intentions, is important for everyday functioning. Among persons living with HIV (PLWH), executive dysfunction is implicated in ProM impairments. However, specific subcomponents of executive functioning involved in ProM deficits remain poorly understood. Unlike more "traditional" neurocognitive (NC) measures of executive functioning associated with dorsolateral prefrontal cortex (i.e., conceptual reasoning, abstraction), those associated with medial orbitofrontal/ventromedial prefrontal (mOF/vmP) cortex (i.e., decision making, inhibitory control, goal-oriented behavior) have yet to be examined in ProM. METHOD This study characterized ProM ability in a sample of 89 HIV-seropositive adults and examined the unique role of decision-making ability in ProM. Participants completed a standard NC battery, the Iowa Gambling Task (IGT; a decision-making measure), and the Memory for Intentions Screening Test (MIST; a ProM measure). RESULTS Correlational analyses revealed that both traditional executive functioning measures and the IGT were associated with ProM. Regression analyses revealed that the IGT significantly predicted ProM, even after accounting for NC measures. Among all NC measures, only executive functioning significantly contributed to ProM. DISCUSSION Further examination of mOF/vmP-sensitive executive dysfunction within this population is needed as PLWH may require more tailored treatment recommendations due to specific decision-making difficulties that can impact medication management.
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Affiliation(s)
- Kelly Coulehan
- a Department of Psychology , Fordham University , Bronx , NY , USA
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Problematic alcohol use among individuals with HIV: relations with everyday memory functioning and HIV symptom severity. AIDS Behav 2014; 18:1302-14. [PMID: 23979498 DOI: 10.1007/s10461-013-0602-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Problematic alcohol use has been shown to negatively impact cognitive functions germane to achieving optimal HIV health outcomes. The present study, a secondary data analysis, examined the impact of problematic alcohol use on aspects of everyday memory functioning in a sample of 172 HIV-infected individuals (22 % female; Mage = 48.37 years, SD = 8.64; 39 % Black/non-Hispanic). Additionally, we tested whether self-reported memory functioning explained the relation between problematic alcohol use and HIV symptom severity. Results indicated that problematic patterns of alcohol use were associated with lower total memory functioning, retrieval (e.g., recall-difficulty) and memory for activity (e.g., what you did yesterday) and greater HIV symptom severity. Memory functioning mediated the relation between problematic alcohol use and HIV symptom severity. However, the direction of this relation was unclear as HIV symptom severity also mediated the relation between problematic alcohol use and memory functioning. Findings highlight the importance of integrated care for HIV and alcohol use disorders and suggest that routine alcohol and cognitive screenings may bolster health outcomes among this vulnerable population.
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Moore RC, Fazeli PL, Jeste DV, Moore DJ, Grant I, Woods SP. Successful cognitive aging and health-related quality of life in younger and older adults infected with HIV. AIDS Behav 2014; 18:1186-97. [PMID: 24633788 PMCID: PMC4020963 DOI: 10.1007/s10461-014-0743-x] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Neurocognitive impairments commonly occur and adversely impact everyday functioning in older adults infected with HIV, but little is known about successful cognitive aging (SCA) and its health-related quality of life (HRQoL) correlates. Seventy younger (≤40 years) and 107 older (≥50 years) HIV+ adults, as well as age-matched seronegative comparison groups of younger (N = 48) and older (N = 77) subjects completed a comprehensive battery of neuropsychological, psychiatric, medical, and HRQoL assessments. SCA was operationalized as the absence of both performance-based neurocognitive deficits and self-reported symptoms (SCA-ANDS) as determined by published normative standards. A stair-step decline in SCA-ANDS was observed in accordance with increasing age and HIV serostatus, with the lowest rates of SCA-ANDS found in the older HIV+ group (19 %). In both younger and older HIV+ adults, SCA-ANDS was strongly related to better mental HRQoL. HIV infection has additive adverse effects on SCA, which may play a unique role in mental well-being among HIV-infected persons across the lifespan.
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Affiliation(s)
- Raeanne C Moore
- Department of Psychiatry (8231), University of California, San Diego, 220 Dickinson St., Suite B, San Diego, CA, 92103, USA,
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Galioto R, Gunstad J, Heinberg LJ, Spitznagel MB. Adherence and weight loss outcomes in bariatric surgery: does cognitive function play a role? Obes Surg 2014; 23:1703-10. [PMID: 23934274 DOI: 10.1007/s11695-013-1060-6] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Although bariatric surgery is the most effective intervention for severe obesity, a significant minority of participants fail to achieve or maintain optimal weight loss at extended follow-up. Accumulating evidence suggests that adherence to prescribed postoperative recommendations, including attendance at follow-up appointments and dietary and physical activity, is related to improved weight loss outcomes. However, adherence to these guidelines presents a significant challenge for many patients, potentially due in part to deficits in cognitive function. In this paper, we briefly examine current literature of adherence on postoperative weight loss outcomes, and review emerging evidence that the cognitive dysfunction present in a subset of obese individuals is related to weight loss outcomes following bariatric procedures. We then extend these findings, positing a role for cognitive function in moderating the relationship between adherence and postoperative outcomes.
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Affiliation(s)
- Rachel Galioto
- Department of Psychology, Kent State University, Kent, OH, 44242, USA,
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Kamat R, Weinborn M, Kellogg EJ, Bucks RS, Velnoweth A, Woods SP. Construct validity of the Memory for Intentions Screening Test (MIST) in healthy older adults. Assessment 2014; 21:742-53. [PMID: 24752386 DOI: 10.1177/1073191114530774] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The Memory for Intentions Screening Test (MIST) is a clinical measure of prospective memory. There is emerging support for the sensitivity and ecological relevance of the MIST in clinical populations. In the present study, the construct validity of the MIST was evaluated in 40 younger (18-30 years), 24 young-old (60-69 years), and 37 old-old (70+ years) healthy adults. Consistent with expectations derived from the prospective memory and aging literature, older adults demonstrated lower scores on the MIST's primary scale scores (particularly on the time-based scale), but slightly better performance on the seminaturalistic 24-hour trial. Among the healthy older adults, the MIST showed evidence of both convergent (e.g., verbal fluency) and divergent (e.g., visuoperception) correlations with standard clinical tests, although the magnitude of those correlations were comparable across the time- and event-based scales. Together, these results support the discriminant and convergent validity of the MIST as a measure of prospective memory in healthy older adults.
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Affiliation(s)
- Rujvi Kamat
- University of California, San Diego, CA, USA San Diego State University, San Diego, CA, USA
| | - Michael Weinborn
- University of Western Australia, Perth, Western Australia, Australia
| | | | - Romola S Bucks
- University of Western Australia, Perth, Western Australia, Australia
| | - Aimee Velnoweth
- University of Western Australia, Perth, Western Australia, Australia
| | - Steven Paul Woods
- University of California, San Diego, CA, USA University of Western Australia, Perth, Western Australia, Australia
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45
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Babson KA, Heinz AJ, Bonn-Miller MO. HIV medication adherence and HIV symptom severity: the roles of sleep quality and memory. AIDS Patient Care STDS 2013; 27:544-52. [PMID: 24032625 DOI: 10.1089/apc.2013.0221] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
The purpose of the current study was to examine the extent to which self-reported sleep quality, a clinically malleable factor, is associated with both HIV medication adherence and self-reported HIV symptom severity. In addition, we sought to examine whether sleep quality may explain the association between HIV medication adherence and symptom severity, as well as the role of self-reported memory functioning in terms of the above relations. This study took place from April 2010 to March 2012. Participants were 129 HIV-positive individuals who completed an ART pill count and series of structured clinical interviews and self-report questionnaires on sleep, memory, and HIV symptom severity. A series of regressions were conducted to test study hypotheses. After accounting for covariates (i.e., problematic alcohol, nicotine, and cannabis use, and mood disorder diagnosis), results indicated that self-reported sleep quality was associated with HIV medication adherence and self-reported HIV symptom severity, and that sleep quality partially mediated the relation between medication adherence and self-reported HIV symptom severity. In addition, memory functioning moderated the relation between self-reported sleep quality and HIV symptom severity, such that the interaction of poor sleep quality and relatively good memory functioning was associated with heightened self-reported HIV symptom severity. This study highlights the importance of assessing sleep and memory among HIV-infected individuals as they may represent treatment targets for those experiencing poor medication adherence or particularly severe HIV symptoms. Such information could lead to the inclusion of adjunct brief interventions to target sleep and memory functioning in order to reduce symptom severity among HIV-positive individuals with poor medication adherence.
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Affiliation(s)
- Kimberly A. Babson
- Center for Innovation to Implementation, VA Palo Alto Health Care System, Menlo Park, California
- Department of Psychiatry and Behavioral Sciences, Stanford School of Medicine, Stanford, California
| | - Adrienne J. Heinz
- Center for Innovation to Implementation, VA Palo Alto Health Care System, Menlo Park, California
- Department of Psychiatry and Behavioral Sciences, Stanford School of Medicine, Stanford, California
| | - Marcel O. Bonn-Miller
- Center for Innovation to Implementation, VA Palo Alto Health Care System, Menlo Park, California
- National Center for PTSD, VA Palo Alto Health Care System, Menlo Park, California
- Center of Excellence in Substance Abuse Treatment and Education, Philadelphia VA Medical Center, Philadelphia, Pennsylvania
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
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Lam JWS, Lui SSY, Wang Y, Chan RCK, Cheung EFC. Prospective memory predicts medication management ability and correlates with non-adherence to medications in individuals with clinically stable schizophrenia. Schizophr Res 2013; 147:293-300. [PMID: 23631929 DOI: 10.1016/j.schres.2013.04.010] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2013] [Revised: 03/14/2013] [Accepted: 04/11/2013] [Indexed: 01/19/2023]
Abstract
BACKGROUND Prospective memory (PM), the ability to remember to carry out an intended action in the future, is thought to relate closely to everyday functioning, such as medication adherence. PM impairment in schizophrenia may contribute to unintentional medication non-adherence. This study aimed to examine the relationship between PM, medication management and medication adherence. METHODS Eighty-two stable patients with schizophrenia underwent assessment for PM and medication management ability by laboratory measures at baseline. Clinical symptoms, other neuropsychological functions and risk factors known to associate with non-adherence were also measured. Linear regression was used to identify predictors of medication management ability at baseline. Actual medication adherence was assessed three months later and logistic regression was used to identify predictors of non-adherence. RESULTS In the linear regression model, time- and event-based PM together accounted for 72.3% of the variance in the performance of medication management at baseline. At three-month follow-up, the non-adherent group performed significantly more poorly in time- and event-based PM, and had poorer insight, more severe symptoms and poorer ability to manage medications, as compared to the adherent group. In the logistic regression model, insight and PANSS general score significantly predicted non-adherence in the community. Time- and event-based PM moderated the predictive power of insight and PANSS general score. CONCLUSIONS Our results support that PM performance robustly predicts medication management ability and may influence medication adherence in the community by moderating the effect of insight and symptom severity. Optimizing PM performance may improve medication adherence in the community, particularly for unintentional non-adherence.
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Affiliation(s)
- Joanna W S Lam
- Castle Peak Hospital, Hong Kong Special Administration Region, China
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Scullin MK, Gordon BA, Shelton JT, Lee JH, Head D, McDaniel MA. Evidence for a detrimental relationship between hypertension history, prospective memory, and prefrontal cortex white matter in cognitively normal older adults. COGNITIVE, AFFECTIVE & BEHAVIORAL NEUROSCIENCE 2013; 13:405-16. [PMID: 23389652 PMCID: PMC3633679 DOI: 10.3758/s13415-013-0152-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Hypertension affects many older adults and is associated with impaired neural and cognitive functioning. We investigated whether a history of hypertension was associated with impairments to prospective memory, which refers to the ability to remember to perform delayed intentions, such as remembering to take medication. Thirty-two cognitively normal older adult participants with or without a history of hypertension (self-reported) performed two laboratory prospective memory tasks, one that relied more strongly on executive control (nonfocal prospective memory) and one that relied more strongly on spontaneous memory retrieval processes (focal prospective memory). We observed hypertension-related impairments for nonfocal, but not focal, prospective memory. To complement our behavioral approach, we conducted a retrospective analysis of available structural magnetic resonance imaging data. Lower white matter volume estimates in the anterior prefrontal cortex were associated with lower nonfocal prospective memory and with a history of hypertension. A history of hypertension may be associated with worsened executive control and lower prefrontal white matter volume. The translational implication is that individuals who must remember to take antihypertensive medications and to monitor their blood pressure at home may be impaired in the executive control process that helps to support these prospective memory behaviors.
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Doyle KL, Loft S, Morgan EE, Weber E, Cushman C, Johnston E, Grant I, Woods SP. Prospective memory in HIV-associated neurocognitive disorders (HAND): the neuropsychological dynamics of time monitoring. J Clin Exp Neuropsychol 2013; 35:359-72. [PMID: 23465043 DOI: 10.1080/13803395.2013.776010] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Strategic monitoring during a delay interval is theorized to be an essential feature of time-based prospective memory (TB PM), the cognitive architecture of which is thought to rely heavily on frontostriatal systems and executive functions. This hypothesis was examined in 55 individuals with HIV-associated neurocognitive disorders (HAND) and 108 seronegative comparison participants who were administered the Memory for Intentions Screening Test (MIST), during which time-monitoring (clock-checking) behavior was measured. Results revealed a significant interaction between HAND group and the frequency of clock checking, in which individuals with HAND checked the clock significantly less often than the comparison group across the TB PM retention intervals of the MIST. Subsequent analyses in the HAND sample revealed that the frequency of clocking checking was positively related to overall TB performance, as well as to standard clinical measures of retrospective memory and verbal fluency. These findings add support to a growing body of research elucidating TB PM's reliance on strategic monitoring processes dependent upon intact frontostriatal systems. HIV-associated TB strategic time-monitoring deficits may manifest in poorer functioning outcomes, including medication nonadherence and dependence in activities of daily living. Future research is needed to further delineate the cognitive mechanisms underlying strategic time monitoring in order to advise rehabilitation strategies for reducing HAND-related TB PM deficits.
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Affiliation(s)
- Katie L Doyle
- Department of Psychiatry, University of California, San Diego, CA 92103, USA
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49
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Poquette AJ, Moore DJ, Gouaux B, Morgan EE, Grant I, Woods SP. Prospective memory and antiretroviral medication non-adherence in HIV: an analysis of ongoing task delay length using the memory for intentions screening test. J Int Neuropsychol Soc 2013; 19:155-61. [PMID: 23095304 PMCID: PMC3693472 DOI: 10.1017/s1355617712001051] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Using multi-process framework by McDaniel and Einstein (2000), the current study examined whether the length of prospective memory (PM) delay intervals as measured by the 2- and 15-min subscales of the Memory for Intentions Screening Test (MIST) have differential predictive value for antiretroviral (ARV) adherence. Participants included 74 HIV-infected individuals whose ARV adherence was tracked with an electronic monitoring system. Participants were classified as "adherent" (n = 49) or "non-adherent" (n = 25) based on recorded pill bottle openings of ≥90% of prescribed doses over 30 days. An adherence group by MIST delay interval interaction was observed, such that non-adherent participants had worse performance on the 15-min, but not 2-min delay PM MIST subscales. The observed MIST 15-min delay effects were significantly more pronounced on time- versus event-cued PM trials. Long-delay time-based PM was predictive of non-adherence independent of demographics, mood state, self-reported adherence, and general cognitive functioning. Findings from this clinical study indicate that ARV non-adherence may be particularly associated with deficits in strategic cue monitoring over longer PM delays, which may inform interventions to improve adherence among persons living with HIV infection.
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Affiliation(s)
- Amelia J. Poquette
- Department of Psychiatry, University of California, San Diego, La Jolla, California
| | - David J. Moore
- Department of Psychiatry, University of California, San Diego, La Jolla, California
| | - Ben Gouaux
- Department of Psychiatry, University of California, San Diego, La Jolla, California
| | - Erin E. Morgan
- Department of Psychiatry, University of California, San Diego, La Jolla, California
| | - Igor Grant
- Department of Psychiatry, University of California, San Diego, La Jolla, California
| | - Steven Paul Woods
- Department of Psychiatry, University of California, San Diego, La Jolla, California
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Blackstone K, Woods SP, Weber E, Grant I, Moore DJ. Memory-based strategies for antiretroviral medication management: an evaluation of clinical predictors, adherence behavior awareness, and effectiveness. AIDS Behav 2013; 17:74-85. [PMID: 22968399 DOI: 10.1007/s10461-012-0308-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
"Forgetting" is the most commonly endorsed reason for missing an antiretroviral therapy (ART) dose, yet little is known about the prevalence, predictors, and effectiveness of the mnemonic strategies to support ART adherence. The current study assessed 28 self-reported memory-based medication strategies in 233 HIV-infected individuals with 30-day ART adherence measured via the medication event monitoring system. Participants endorsed using multiple (8.7 ± 5.6) strategies with the most common being internally-driven. More frequent strategy use was uniquely associated with affective distress, dependent daily functioning, higher non-ART pill burden, and poorer ART adherence. Individuals who used strategies frequently, but perceived them as minimally effective, had more affective, physical, and functional distress. More frequent strategy use was associated with worse ART adherence and was unrelated to perceived effectiveness. Primary reliance on internally-based mnemonic strategies may reflect a lack of awareness of adherence behaviors and may be insufficient to support optimal ART adherence in vulnerable populations.
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