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Cognitive reserve profiles are associated with outcome in schizophrenia. J Neurol Sci 2022; 443:120496. [PMID: 36410188 DOI: 10.1016/j.jns.2022.120496] [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: 05/17/2022] [Revised: 10/17/2022] [Accepted: 11/12/2022] [Indexed: 11/17/2022]
Abstract
Cognitive reserve (CR), the brain's ability to cope with brain pathology to minimize symptoms, could explain the heterogeneity of outcomes in neuropsychiatric disorders, however it is still rarely investigated in schizophrenia. Indeed, this study aims to classify CR in this disorder and evaluate its impact on neurocognitive and socio-cognitive performance and daily functioning. A group of 106 patients diagnosed with schizophrenia was enrolled and assessed in these aereas: neurocognition, Theory of Mind (ToM) and daily functioning. A composite CR score was determined through an integration of the intelligence quotient and education and leisure activities. CR profiles were classified with a two-step cluster analysis and differences among clusters were determined with an analysis of variance (ANOVA). The cluster analysis was identified with three CR profiles characterized, respectively, by high, medium and low CR. ANOVA analysis showed significant differences on neurocognition, ToM and daily functioning between the clusters: people with higher CR reached significantly superior scores. This study suggests that greater general cognitive resources could act as a buffer against the effect of brain pathology, allowing patients to have a better cognitive performance, social outcome and quality of life.
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Buda A, Dean O, Adams HR, Mwanza-Kabaghe S, Potchen MJ, Mbewe EG, Kabundula PP, Mweemba M, Matoka B, Mathews M, Menon JA, Wang B, Birbeck GL, Bearden DR. Neighborhood-Based Socioeconomic Determinants of Cognitive Impairment in Zambian Children With HIV: A Quantitative Geographic Information Systems Approach. J Pediatric Infect Dis Soc 2021; 10:1071-1079. [PMID: 34437702 PMCID: PMC8719623 DOI: 10.1093/jpids/piab076] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Accepted: 08/02/2021] [Indexed: 01/04/2023]
Abstract
BACKGROUND Place-based inequalities, such as exposure to violence and access to nutritious food and clean water, may contribute to human immunodeficiency virus (HIV)-associated cognitive impairment. In this study, we investigated neighborhood effects on cognition in children and adolescents with HIV in Lusaka, Zambia. METHODS We conducted a prospective cohort study of 208 children with perinatally acquired HIV (ages 8-17) and 208 HIV-exposed uninfected controls. Participants underwent neuropsychological testing and interviews assessing socioeconomic status. Geographic regions with clusters of participants with HIV and cognitive impairment were identified using quantitative geographic information systems (QGIS) and SaTScan. Associations between location of residence and cognitive function were evaluated in bivariable and multivariable regression models. Mediation analysis was performed to assess direct and indirect effects of location of the residence on cognitive impairment. RESULTS Residence in Chawama, one of the poorest neighborhoods in Lusaka, was significantly associated with cognitive impairment in participants with HIV (odds ratio 2.9; P = .005) and remained significant in a multivariable regression model controlling for potential confounders. Mediation analysis found that 46% of the cognitive effects of residence in Chawama were explained by higher rates of malnutrition, lower school attendance, and poorer self-reported health. CONCLUSIONS Place-based socioeconomic inequality contributes to cognitive impairment in Zambian children and adolescents with HIV. Neighborhood effects may be mediated by concentrated poverty, malnutrition, limited access to education and health care, and other yet unknown environmental factors that may be potentially modifiable.
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Affiliation(s)
- Alexandra Buda
- University of Rochester School of Medicine, Rochester, New York, USA
| | - Owen Dean
- University of Rochester School of Medicine, Rochester, New York, USA
| | - Heather R Adams
- University of Rochester School of Medicine, Rochester, New York, USA,Department of Neurology, Division of Child Neurology, University of Rochester School of Medicine, Rochester, New York, USA
| | | | - Michael J Potchen
- Department of Imaging Sciences, University of Rochester School of Medicine, Rochester, New York, USA,Lusaka Apex Medical University, Lusaka, Zambia
| | - Esau G Mbewe
- Department of Educational Psychology, University of Zambia, Lusaka, Zambia
| | | | - Milimo Mweemba
- Neurology Research Office, University Teaching Hospital, Lusaka, Zambia
| | - Beauty Matoka
- Neurology Research Office, University Teaching Hospital, Lusaka, Zambia
| | - Manoj Mathews
- University of Zambia School of Medicine, Lusaka, Zambia,University Teaching Hospital Children’s Hospital, Lusaka, Zambia,Directorate of Clinical Care & Diagnostics Services, Ministry of Health, Lusaka, Zambia
| | - J Anitha Menon
- Department of Psychology, University of Zambia, Lusaka, Zambia
| | - Bo Wang
- Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, Massachusetts, US
| | - Gretchen L Birbeck
- Neurology Research Office, University Teaching Hospital, Lusaka, Zambia,University of Zambia School of Medicine, Lusaka, Zambia,Department of Neurology, Division of Epilepsy, University of Rochester School of Medicine, Rochester, New York, USA
| | - David R Bearden
- Department of Neurology, Division of Child Neurology, University of Rochester School of Medicine, Rochester, New York, USA,Department of Educational Psychology, University of Zambia, Lusaka, Zambia,Corresponding Author: David R. Bearden, MD, MSCE, Department of Neurology, Division of Child Neurology, University of Rochester School of Medicine, 601 Elmwood Avenue, Box 631, Rochester, New York, NY 14642, USA. E-mail:
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Neuropsychiatric Disorders, Emotional Disturbances, and Their Associations with HIV-Associated Neurocognitive Disorder. Curr Top Behav Neurosci 2021; 50:347-366. [PMID: 34081306 DOI: 10.1007/7854_2021_233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
The current chapter provides a critical and narrative review of recent research on the neuropsychiatric disorders, emotional disturbances, and their associations with neurocognitive functioning in people living with HIV infection. We review a range of neuropsychiatric disorders including depression and anxiety disorders, but also emotional disturbances, which can be partly distinguished from depression and anxiety (apathy, alexithymia, and emotional processing impairment). While reviewing the research into the neuropsychiatric disorders and HIV-associated neurocognitive disorders, we also cover the questions of self-reported cognitive symptoms evaluation and interpretation. The chapter includes research on the role of coping skills, perceived stress and response to stressful life events, and connections to neurocognitive impairment in people living with HIV. Promising non-pharmacological interventions are highlighted. The chapter concludes with the clinical implications on how to best consider neuropsychiatric disorders and cognitive symptoms for the diagnosis of HIV-associated neurocognitive disorders, as well as future research directions.
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Gouse H, Masson CJ, Henry M, Thomas KGF, Robbins RN, Kew G, London L, Joska JA, Marcotte TD. The Impact of HIV-Associated Neurocognitive Impairment on Driving Performance in Commercial Truck Drivers. AIDS Behav 2021; 25:689-698. [PMID: 32910354 DOI: 10.1007/s10461-020-03033-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Driving ability can be diminished amongst people with HIV with associated neurocognitive impairment (NCI). We explore the relationship between HIV status, NCI and driving ability in professional truck drivers. Forty male professional drivers (20 HIV-positive; mean age = 39.20 ± 7.05) completed a neuropsychological test battery, two driving simulator tasks that assessed driving ability, and a driving history and habits questionnaire. A higher proportion of HIV-positive drivers exhibited impaired overall cognitive performance (p ≤ 0.001). Overall, drivers with NCI (defined as z ≤ 1.00) were more likely than those without NCI to crash (p = 0.002). There were no significant between-group (HIV-positive versus HIV-negative) differences with regard to self-reported on-road driving events. Professional drivers with NCI, as measured on a driving simulator, are at increased risk of making driving errors under high-risk conditions compared to their neurocognitively normal counterparts. These data should inform driver health management with regard to annual medical screening and surveillance.
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Affiliation(s)
- H Gouse
- HIV Mental Health Research Unit and Neurosciences Institute, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa.
| | - C J Masson
- HIV Mental Health Research Unit and Neurosciences Institute, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - M Henry
- Centre for Higher Education Development, University of Cape Town, Cape Town, South Africa
| | - K G F Thomas
- ACSENT Laboratory, Department of Psychology, University of Cape Town, Cape Town, South Africa
| | - R N Robbins
- HIV Center for Clinical and Behavioral Science, New York State Psychiatric Institute and Columbia University, New York, NY, USA
| | - G Kew
- School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
| | - L London
- School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
| | - J A Joska
- HIV Mental Health Research Unit and Neurosciences Institute, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - T D Marcotte
- HIV Neurovehavioral Research Program, Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
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Brief Report: Higher Peripheral Monocyte Activation Markers Are Associated With Smaller Frontal and Temporal Cortical Volumes in Women With HIV. J Acquir Immune Defic Syndr 2020; 84:54-59. [PMID: 31914004 DOI: 10.1097/qai.0000000000002283] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
BACKGROUND Persistent inflammation is a life-long complication of HIV infection, even in virally suppressed individuals. Elevated plasma concentrations of soluble(s) CD14 and CD163 have been established as biomarkers of chronic inflammation, conferring higher risk for cognitive, neurovascular, and structural abnormalities. METHODS Structural magnetic resonance imaging (frontal and temporal regions) as well as plasma inflammatory biomarkers of monocyte activation (sCD14 and sCD163), general inflammation (plasma C-reactive protein, interleukin[IL]-6), and gut microbial translocation (plasma intestinal fatty acid-binding protein) were available on 38 women (25 with HIV) from the Chicago Women's Interagency HIV Study site. Partial least-squares models adjusting for relevant covariates (eg, age, education, and race) were conducted to evaluate the relationship between inflammatory biomarkers and brain volume in the overall sample and among women with HIV (WWH). RESULTS In the total sample, higher plasma sCD14 was associated with smaller volumes in multiple frontal and temporal lobe regions. In the WWH-only sample, sCD163 was associated with smaller volumes only in one region of the left frontal lobe. C-reactive protein, IL-6, and intestinal fatty acid-binding protein were not associated with brain volumes for either group of women. CONCLUSIONS Of the inflammatory monocyte markers evaluated, sCD14 was associated with smaller frontal and temporal cortical volume in the overall and WWH-only samples, while plasma sCD163 was only associated with smaller left caudal middle frontal gyrus in the WWH-only group. Validating these monocyte proteins as neurological biomarkers of structural brain deficits in a larger sample is critical for understanding HIV-associated neurobiological complications.
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Addington EL, Javandel S, De Gruttola V, Paul R, Milanini B, Ances BM, Moskowitz JT, Valcour V. Mindfulness-based stress reduction for HIV-associated neurocognitive disorder: Rationale and protocol for a randomized controlled trial in older adults. Contemp Clin Trials 2020; 98:106150. [PMID: 32942053 PMCID: PMC7686285 DOI: 10.1016/j.cct.2020.106150] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 09/04/2020] [Accepted: 09/10/2020] [Indexed: 11/29/2022]
Abstract
The symptom burden of HIV-associated neurocognitive disorder (HAND) is high among older individuals, and treatment options are limited. Mindfulness-based stress reduction (MBSR) has potential to improve neurocognitive performance, psychosocial wellbeing, and quality of life, but empirical studies in this growing vulnerable population are lacking. In this trial, participants (N = 180) age 55 and older who are living with HIV infection, are on combination antiretroviral therapy with suppressed viral loads, and yet continue to experience behavioral and cognitive symptoms of HAND, are randomized to MBSR or to a waitlist control arm that receives MBSR following a 16-week period of standard care. Primary outcomes (attention, executive function, stress, anxiety, depression, everyday functioning, quality of life) and potential mediators (affect, mindfulness) and moderators (social support, loneliness) are assessed at baseline and weeks 8, 16, and 48 in both groups, with an additional assessment at week 24 (post-MBSR) in the crossover control group. Assessments include self-report and objective measures (e.g., neuropsychological assessment, neurological exam, clinical labs). In addition, a subset of participants (n = 30 per group) are randomly selected to undergo fMRI to evaluate changes in functional connectivity networks and their relationship to changes in neuropsychological outcomes. Forthcoming findings from this randomized controlled trial have the potential to contribute to a growing public health need as the number of older adults with HAND is expected to rise.
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Affiliation(s)
- Elizabeth L Addington
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA; Osher Center for Integrative Medicine, Northwestern University, Chicago, IL, USA.
| | - Shireen Javandel
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, California, USA
| | - Victor De Gruttola
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Robert Paul
- Missouri Institute of Mental Health, University of Missouri-St. Louis, St. Louis, MO, USA
| | - Benedetta Milanini
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, California, USA
| | - Beau M Ances
- Department of Neurology, Washington University in St. Louis, School of Medicine, St. Louis, MO, USA
| | - Judith T Moskowitz
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA; Osher Center for Integrative Medicine, Northwestern University, Chicago, IL, USA
| | - Victor Valcour
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, California, USA
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7
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Kaur N, Dendukuri N, Fellows LK, Brouillette MJ, Mayo N. Association between cognitive reserve and cognitive performance in people with HIV: a systematic review and meta-analysis. AIDS Care 2019; 32:1-11. [PMID: 31084206 DOI: 10.1080/09540121.2019.1612017] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Cognitive reserve is a potential explanation for the disparity between brain pathology and its clinical manifestations. The main objective of this study was to estimate, based on published studies, the strength of the association between cognitive reserve and cognitive performance in individuals with HIV. A systematic literature search using Ovid MEDLINE, PsychINFO, and EMBASE was performed to identify studies published between 1990 and 2016 that quantified the association between cognitive reserve and cognitive performance in HIV. A random-effects meta-analysis was used to compute a summary estimate (Cohen's d) with 95% confidence intervals (CI) and 95% prediction intervals (PI). The risk of bias and quality of reporting in the studies were indicated by the Appraisal tool for Cross-Sectional Studies (AXIS). Ten observational studies were deemed eligible. The pooled effect size was 0.9 (95% CI: 0.7-1.0; 95% PI: 0.4-1.4) with marked heterogeneity studies [Cochran's Q (df = 9) = 28.0, p = .0009; I2 statistic = 67.4%]. Risk-of-bias appraisal showed that non-response bias was never addressed and the items associated with selection bias were only partially met. The association between cognitive reserve and cognitive performance suggests that building reserve through non-pharmacological interventions could be a potentially effective way of combating cognitive impairment in people with HIV.
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Affiliation(s)
- Navaldeep Kaur
- School of Physical and Occupational Therapy, McGill University, Montreal, Canada.,Division of Clinical Epidemiology, McGill University, Montreal, Canada.,Center for Outcomes Research and Evaluation, Research Institute, McGill University Health Centre, Montreal, Canada
| | - Nandini Dendukuri
- Division of Clinical Epidemiology, McGill University, Montreal, Canada
| | - Lesley K Fellows
- Department of Neurology and Neurosurgery, McGill University, Montreal, Canada
| | | | - Nancy Mayo
- School of Physical and Occupational Therapy, McGill University, Montreal, Canada.,Division of Clinical Epidemiology, McGill University, Montreal, Canada.,Center for Outcomes Research and Evaluation, Research Institute, McGill University Health Centre, Montreal, Canada
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8
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Amoretti S, Cabrera B, Torrent C, Mezquida G, Lobo A, González-Pinto A, Parellada M, Corripio I, Vieta E, de la Serna E, Butjosa A, Contreras F, Sarró S, Penadés R, Sánchez-Torres AM, Cuesta M, Bernardo M. Cognitive reserve as an outcome predictor: first-episode affective versus non-affective psychosis. Acta Psychiatr Scand 2018; 138:441-455. [PMID: 30105820 DOI: 10.1111/acps.12949] [Citation(s) in RCA: 54] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/25/2018] [Indexed: 02/06/2023]
Abstract
OBJECTIVE Cognitive reserve (CR) refers to the brain's capacity to cope with pathology in order to minimize the symptoms. CR is associated with different outcomes in severe mental illness. This study aimed to analyze the impact of CR according to the diagnosis of first-episode affective or non-affective psychosis (FEP). METHOD A total of 247 FEP patients (211 non-affective and 36 affective) and 205 healthy controls were enrolled. To assess CR, common proxies have been integrated (premorbid IQ; education-occupation; leisure activities). The groups were divided into high and low CR. RESULTS In non-affective patients, those with high CR were older, had higher socioeconomic status (SES), shorter duration of untreated psychosis, and a later age of onset. They also showed greater performance in most cognitive domains. In affective patients, those with a greater CR showed a higher SES, better functioning, and greater verbal memory performance. CONCLUSION CR plays a differential role in the outcome of psychoses according to the diagnosis. Specifically, in order to address the needs of non-affective patients with low CR, cognitive rehabilitation treatments will need to be 'enriched' by adding pro-cognitive pharmacological agents or using more sophisticated approaches. However, a functional remediation therapy may be of choice for those with an affective psychosis and low CR.
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Affiliation(s)
- S Amoretti
- Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, Neuroscience Institute, University of Barcelona, Barcelona, Spain.,Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain
| | - B Cabrera
- Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, Neuroscience Institute, University of Barcelona, Barcelona, Spain.,Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain
| | - C Torrent
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain.,August Pi I Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain.,Barcelona Bipolar Disorders Program, Institute of Neurosciences, University of Barcelona, Barcelona, Spain
| | - G Mezquida
- Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, Neuroscience Institute, University of Barcelona, Barcelona, Spain.,Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain
| | - A Lobo
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain.,Department of Medicine and Psychiatry, Zaragoza University, Instituto de Investigación Sanitaria Aragón (IIS Aragón), Zaragoza, Spain
| | - A González-Pinto
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain.,Araba University Hospital, Bioaraba Research Institute, Vitoria, Spain.,University of the Basque Country (UPV-EHU), Vitoria, Spain
| | - M Parellada
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain.,Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, Madrid, Spain
| | - I Corripio
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain.,Department of Psychiatry, Institut d'Investigació Biomèdica-Sant Pau (IIB-SANT PAU), Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - E Vieta
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain.,August Pi I Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain.,Barcelona Bipolar Disorders Program, Institute of Neurosciences, University of Barcelona, Barcelona, Spain
| | - E de la Serna
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain.,Department of Child and Adolescent Psychiatry and Psychology, Hospital Clinic of Barcelona, Barcelona, Spain
| | - A Butjosa
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain.,Parc Sanitari Sant Joan de Déu, Institut de Recerca Sant Joan de Déu, SantBoi de Llobregat, Barcelona, Spain.,Fundació Sant Joan de Déu, Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain
| | - F Contreras
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain.,Psychiatry Department, Bellvitge University Hospital-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
| | - S Sarró
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain.,FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain.,Neuroscience Research Australia, Sydney, NSW, Australia.,School of Medical Sciences, University of New South Wales, Sydney, NSW, Australia.,ARC Centre of Excellence in Cognition and its Disorders, Sydney, NSW, Australia
| | - R Penadés
- Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, Neuroscience Institute, University of Barcelona, Barcelona, Spain.,Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain.,August Pi I Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
| | - A M Sánchez-Torres
- Department of Psychiatry, Complejo Hospitalario de Navarra, Pamplona, Spain.,IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
| | - M Cuesta
- Department of Psychiatry, Complejo Hospitalario de Navarra, Pamplona, Spain.,IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
| | - M Bernardo
- Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, Neuroscience Institute, University of Barcelona, Barcelona, Spain.,Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain.,August Pi I Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
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Moore RC, Hussain MA, Watson CWM, Fazeli PL, Marquine MJ, Yarns BC, Jeste DV, Moore DJ. Grit and Ambition are Associated with Better Neurocognitive and Everyday Functioning Among Adults Living with HIV. AIDS Behav 2018; 22:3214-3225. [PMID: 29455265 DOI: 10.1007/s10461-018-2061-1] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Grit and ambition are psychological factors that may protect neurocognitive function among persons living with HIV (PLWH). We examined associations between grit, ambition, premorbid verbal intellectual function, and current neurocognitive and everyday functioning among PLWH and persons without HIV (HIV-). 120 PLWH and 94 HIV- adults completed the Grit Scale (includes total score and consistency of interests and perseverance of effort subscales), ambition scale, and a comprehensive neurobehavioral battery. PLWH had lower grit scores than HIV- adults. The two groups did not differ on ambition. No relationship was observed between grit and cognition among HIV- adults. Among PLWH, however, higher perseverance of effort and more ambition was related to better global neurocognitive functioning, and higher grit, but not ambition, was related to independence in daily functioning. Longitudinal studies are needed to elucidate these relationships over time and examine whether grit or ambition have protective effects on cognitive outcomes among PLWH.
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Affiliation(s)
- Raeanne C Moore
- Department of Psychiatry, University of California, San Diego, 220 Dickinson Drive, St B (8231), San Diego, CA, 92103-8231, USA.
- VA San Diego Healthcare System, San Diego, CA, USA.
| | - Mariam A Hussain
- San Diego Joint Doctoral Program in Clinical Psychology, San Diego State University, University of California, San Diego, CA, USA
| | - Caitlin W-M Watson
- San Diego Joint Doctoral Program in Clinical Psychology, San Diego State University, University of California, San Diego, CA, USA
| | - Pariya L Fazeli
- Department of Family, Community, and Health Systems, School of Nursing, University of Alabama at Birmingham, Birmingham, AL, USA
| | - María J Marquine
- Department of Psychiatry, University of California, San Diego, 220 Dickinson Drive, St B (8231), San Diego, CA, 92103-8231, USA
| | - Brandon C Yarns
- Department of Medicine, Division of General Internal Medicine, UCLA David Geffen School of Medicine, Los Angeles, CA, USA
- Department of Psychiatry (BCY), VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA
| | - Dilip V Jeste
- Department of Psychiatry, University of California, San Diego, 220 Dickinson Drive, St B (8231), San Diego, CA, 92103-8231, USA
- Department of Neurosciences, University of California, San Diego, CA, USA
- Sam and Rose Stein Institute for Research on Aging, University of California, San Diego, CA, USA
| | - David J Moore
- Department of Psychiatry, University of California, San Diego, 220 Dickinson Drive, St B (8231), San Diego, CA, 92103-8231, USA
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Stoff DM, Colosi D, Rubtsova A, Wingood G. HIV and Aging Research in Women: An Overview. Curr HIV/AIDS Rep 2017; 13:383-391. [PMID: 27771876 DOI: 10.1007/s11904-016-0338-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
This paper reviews some background issues as a foundation to place the ensuing supplement papers of this special issue section in context. The articles in this special supplement issue deepen and expand our understanding of biomedical, neurocognitive, and psychosocial aspects involved in human immunodeficiency virus (HIV) of older women, primarily through the use of the Women's Interagency HIV Study (WIHS) prospective cohort study. As it relates to research on the intersection between HIV and aging in women, we discuss (i) epidemiology as introduction, (ii) the cohort study design featuring the WIHS, (iii) definitions, (iv) models, and (v) section articles.
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Affiliation(s)
- David M Stoff
- National Institute of Mental Health, Bethesda, MD, USA.
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11
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Amoretti S, Bernardo M, Bonnin CM, Bioque M, Cabrera B, Mezquida G, Solé B, Vieta E, Torrent C. The impact of cognitive reserve in the outcome of first-episode psychoses: 2-year follow-up study. Eur Neuropsychopharmacol 2016; 26:1638-48. [PMID: 27511320 DOI: 10.1016/j.euroneuro.2016.07.003] [Citation(s) in RCA: 77] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/29/2016] [Revised: 06/20/2016] [Accepted: 07/02/2016] [Indexed: 12/17/2022]
Abstract
The concept of cognitive reserve (CR) suggests that the premorbid intelligence quotient (IQ), years of education and leisure activities provide more efficient cognitive networks and therefore allow a better management of some conditions associated to cognitive impairment. Fifty-two DSM-IV diagnosed FEP subjects were matched with 41 healthy controls by age, gender and parental socio-economic status. All subjects were assessed clinically, neuropsychologically and functionally at baseline and after a two-year follow-up. To assess CR at baseline, three proxies have been integrated: premorbid IQ, years of education-occupation and leisure activities. Higher CR was associated with better cognitive, functional and clinical outcomes at baseline. The CR proxy was able to predict working memory, attention, executive functioning, verbal memory and global composite cognitive score accounting for 48.9%, 19.1%, 16.9%, 10.8% and 14.9% respectively of the variance at two-year follow-up. CR was also significantly predictive of PANSS negative scale score (12.5%), FAST global score (13.4%) and GAF (13%) at two-year follow-up. In addition, CR behaved as a mediator of working memory (B=4.123) and executive function (B=3.298) at baseline and of working memory (B=5.034) at 2-year follow-up. An additional analysis was performed, in order to test whether this mediation could be attributed mainly to the premorbid IQ. We obtained that this measure was not enough by itself to explain this mediation. CR may contribute to neuropsychological and functional outcome. Specific programs addressed to improve cognition and functioning conducted at the early stages of the illness may be helpful in order to prevent cognitive and functional decline.
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Affiliation(s)
- S Amoretti
- Barcelona Clinic Schizophrenia Unit, Neuroscience Institute, Hospital Clinic of Barcelona, Spain
| | - M Bernardo
- Barcelona Clinic Schizophrenia Unit, Neuroscience Institute, Hospital Clinic of Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain; Institut d׳Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Spain.
| | - C M Bonnin
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain; Institut d׳Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Spain; Barcelona Bipolar Disorders Program, Institute of Neurosciences, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - M Bioque
- Barcelona Clinic Schizophrenia Unit, Neuroscience Institute, Hospital Clinic of Barcelona, Spain
| | - B Cabrera
- Barcelona Clinic Schizophrenia Unit, Neuroscience Institute, Hospital Clinic of Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain
| | - G Mezquida
- Barcelona Clinic Schizophrenia Unit, Neuroscience Institute, Hospital Clinic of Barcelona, Spain
| | - B Solé
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain; Institut d׳Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Spain; Barcelona Bipolar Disorders Program, Institute of Neurosciences, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - E Vieta
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain; Institut d׳Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Spain; Barcelona Bipolar Disorders Program, Institute of Neurosciences, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - C Torrent
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain; Institut d׳Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Spain; Barcelona Bipolar Disorders Program, Institute of Neurosciences, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
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HIV-associated neurocognitive disorders: the relationship of HIV infection with physical and social comorbidities. BIOMED RESEARCH INTERNATIONAL 2015; 2015:641913. [PMID: 25815329 PMCID: PMC4359826 DOI: 10.1155/2015/641913] [Citation(s) in RCA: 84] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/23/2014] [Accepted: 01/29/2015] [Indexed: 12/14/2022]
Abstract
The prevalence of HIV (human immunodeficiency virus) associated neurocognitive disorders (HAND) will undoubtedly increase with the improved longevity of HIV-infected persons. HIV infection, itself, as well as multiple physiologic and psychosocial factors can contribute to cognitive impairment and neurologic complications. These comorbidities confound the diagnosis, assessment, and interventions for neurocognitive disorders. In this review, we discuss the role of several key comorbid factors that may contribute significantly to the development and progression of HIV-related neurocognitive impairment, as well as the current status of diagnostic strategies aimed at identifying HIV-infected individuals with impaired cognition and future research priorities and challenges.
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Abstract
PURPOSE OF REVIEW People with HIV continue to live with the health consequences of an episodic illness that limits their ability to fully participate in society, particularly for the growing number of older people living with HIV. The present review describes the recent evidence exploring the psychosocial challenges facing older adults living with HIV. RECENT FINDINGS Aging for people with HIV may be more challenging than for the general population because of HIV-related stigma, loss of friends and social networks, and the detrimental effects that HIV and antiretroviral treatment have on normal aging processes. Older people with HIV are more likely to experience mental health and neurocognitive impairment than their HIV-negative counterparts, as well as more social isolation as a result of decreased social participation and engagement. People develop different approaches for coping with the challenges associated with aging with HIV. SUMMARY As this field of research evolves, many research gaps need to be addressed, including a better conceptualization and measurement of successful aging and the development of high-quality integrated care, programs, and services tailored to the needs of older people with HIV. A more integrated policy response is needed to improve the psychosocial and economic well being of older people with HIV.
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Cognitive Reserve and Alzheimer’s Disease. Mol Neurobiol 2014; 51:187-208. [DOI: 10.1007/s12035-014-8720-y] [Citation(s) in RCA: 72] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2014] [Accepted: 04/17/2014] [Indexed: 12/13/2022]
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