Objective memory as an indicator of functional impairment in native Spanish-speaking patients with HIV infection

Verbal Memory Performance and Depressive Symptoms in Persons with Treated HIV

The link between memory and comorbid depression in persons with HIV (PWH) is unclear based on evidence from published cohorts. We compared verbal memory in the HVLT-R in a well-characterized HIV cohort (n = 354) with (n = 102) or without (n = 252) comorbid depressive symptoms, and examined memory correlates in both scenarios. Memory fell within unimpaired ranges, but was lower in depressed than non-depressed PWH. Memory was related to quality of life, sociodemographic, and mental health factors, but not to assessed HIV-related or antiretroviral factors. However, longitudinally (n = 52) memory declined with presence and severity of depressive symptoms. In this treated cohort, verbal memory was unrelated to HIV-related variables but to quality of life and depressive symptoms. Greater performance decline over time also related to acute or ongoing depressive symptoms. These findings highlight the importance of addressing comorbid depressive symptoms to improve quality of life in persons with treated HIV.

Assessment of executive functions as a measure of impairments in everyday functioning in persons with HIV

Persons with HIV can often present cognitive disorders such as those related to executive functioning, which could affect the daily life activities. The present study was designed to explore the predictive relationship between executive functions according to Miyake's model and the basic and instrumental skills of everyday functioning in a group of persons with HIV (PWH). Participants were recruited from outpatient treatment Hospital and assessed using a neuropsychological battery, a modified version of the Lawton and Brody basic and instrumental activities of daily life (ADL) scale and the Hospital Anxiety and Depression Scale (HADS). The results showed a low score in the executive function and significant relationship between executive functioning and the instrumental skills of the patients, with set-shifting being one of the most powerful predictors. The processes of executive functioning, particularly set-shifting, are related to the level of functioning in the skills required for independent living in the community, but not the skills of independent living in the home. This study seems to suggest the utility of assessing executive functions as a preventive measure for the development of dependencies in normal daily instrumental skills and as the focus of interdisciplinary interventions.

Recent cocaine use and memory impairment in HIV

Both Human Immunodeficiency Virus (HIV) and cocaine use have been associated with impairment in neuropsychological functioning. The high comorbidity between HIV and cocaine use highlights the importance of ascertaining whether there is a compounding effect of cocaine use in individuals with HIV. Among neuropsychological domains impacted by HIV, verbal memory deficits have received substantial attention partly because they have been associated with declines in functional status in HIV positive individuals. We collected California Verbal Learning Test-II data from HIV participants who met lifetime diagnostic criteria of cocaine abuse and/or dependence (HIV/CocDx+, N = 80 & HIV/CocDx-, N = 30, respectively) and those with and without recent cocaine use, which was confirmed by toxicology analysis (HIV/Coc+, N = 56 & HIV/Coc-, N = 57, respectively). The Item Specific Deficit Approach (ISDA) was employed to determine any additional cocaine-associated deficits in encoding, consolidation, and retrieval, which attempts to control for potential confounding factors of memory such as attention. Using conventional methods of evaluating memory profiles, we found that the HIV/Coc + group demonstrated worse learning, immediate and delayed free recall, and recognition in contrast to the HIV/Coc - group; although using the ISDA, we found that encoding was the only significant difference between HIV/Coc + and HIV/Coc-participant, with HIV/Coc - performing better. Our data suggest that for individuals with HIV, cocaine use is associated with a temporary decline in verbal memory, is characterized by greater encoding deficits, and these effects may reduce with abstinence. Clinically, our findings suggest that reduced encoding is the likely contributor to verbal memory decline in HIV/Coc + and these effects are partially reversible-at least to the level of their HIV/Coc - counterparts.