Is prospective memory a dissociable cognitive function in HIV infection?

Department of Psychiatry, University of California, San Diego, CA 92103, USA.
Journal of Clinical and Experimental Neuropsychology (Impact Factor: 2.08). 10/2010; 32(8):898-908. DOI: 10.1080/13803391003596470
Source: PubMed


An emerging literature indicates that HIV infection is associated with deficits in prospective memory (ProM), or the ability to execute a future intention. This literature offers evidence of neurobiological dissociability of ProM from other cognitive abilities and its incremental ecological validity as a predictor of poorer everyday functioning outcomes (e.g., medication nonadherence). The present study evaluated the hypothesis that ProM represents a unique cognitive construct in HIV disease. A confirmatory 4-factor structural equation model was tested on data derived from 162 participants with HIV. The model posited that measures of ProM comprise a unique factor, apart from standard clinical tests of retrospective memory, executive functions, and motor skills. The fit of the model was evaluated using the Bollen-Stine bootstrap method and indicated that a 4-factor model with measures of ProM loading on a unique factor fit the data well, and better than a model with a single common factor hypothesized to drive cognitive performance. The results of this study lend further evidence to the dissociability of ProM in HIV infection, are consistent with prior studies in healthy adults, and contribute to a growing literature on the construct validity of ProM in HIV disease.

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Available from: Steven Paul Woods, Dec 27, 2013
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    • "Persons living with HIV disease commonly experience failures in prospective memory (PM; Carey et al., 2006), which involves the ability to successfully execute an intended action in response to specific cues that are based on time (e.g., attending a medical appointment at 3 PM) or an event (e.g., take a medication after a meal). Although PM deficits correlate with executive dysfunction, retrospective memory impairment, and slowed information processing in HIV disease (e.g., Zogg et al., 2011), they are also separable from HIV-associated neurocognitive deficits as supported by evidence from biomarker (Woods et al., 2006), cognitive (Gupta et al., 2010), and real-world functioning (e.g., Woods et al., 2008) studies. HIV-associated PM deficits are of clinical concern, as they are associated with engagement in HIV transmission risk behaviors (e.g., Martin et al., 2007) and increased odds of functional dependence (e.g., Woods et al., 2008), including suboptimal adherence to combination antiretroviral therapies (cART; Woods et al., 2009). "
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    ABSTRACT: Two experiments were conducted to examine the effects of task importance on event-based prospective memory (PM) in separate samples of adults with HIV-associated neurocognitive disorders (HAND) and HIV-infected young adults with substance use disorders (SUD). All participants completed three conditions of an ongoing lexical decision task: (1) without PM task requirements; (2) with PM task requirements that emphasized the importance of the ongoing task; and (3) with PM task requirements that emphasized the importance of the PM task. In both experiments, all HIV+ groups showed the expected increase in response costs to the ongoing task when the PM task's importance was emphasized. In Experiment 1, individuals with HAND showed significantly lower PM accuracy as compared to HIV+ subjects without HAND when the importance of the ongoing task was emphasized, but improved significantly and no longer differed from HIV+ subjects without HAND when the PM task was emphasized. A similar pattern of findings emerged in Experiment 2, whereby HIV+ young adults with SUD (especially cannabis) showed significant improvements in PM accuracy when the PM task was emphasized. Findings suggest that both HAND and SUD may increase the amount of cognitive attentional resources that need to be allocated to support PM performance in persons living with HIV infection. (JINS, 2014, 21, 1-11).
    Journal of the International Neuropsychological Society 05/2014; 20(6):1-11. DOI:10.1017/S1355617714000435 · 2.96 Impact Factor
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    • "The current literature base provides support for the inter-rater reliability and internal consistency of the MIST (Woods, Moran, Dawson, et al., 2008). The MIST correlates with other well-validated clinical measures of memory and executive functions in studies of diverse clinical populations such as HIV infection, (Gupta et al., 2010), schizophrenia (Woods et al., 2007), and Parkinson's disease (Raskin et al., 2011). The MIST also differentiates healthy adults from populations with HIV infection (Carey et al., 2006), substance use disorders (e.g., Iudicello et al., 2011; Weinborn, Woods, O'Toole, Kellogg, & Moyle, 2011), schizophrenia (Twamley et al., 2008; Woods, et al., 2007), traumatic brain injury (Fleming, Shum, Strong, & Lightbody, 2005; Tay, Ang, Lau, Meyyappan, & Collinson, 2010), mild cognitive impairment (e.g., Karantzoulis, Troyer, & Rich, 2009), and Parkinson's disease (Raskin et al., 2011). "
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    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.
    Assessment 04/2014; 21(6). DOI:10.1177/1073191114530774 · 3.29 Impact Factor
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    • "Conversely, performance was scored as " incomplete " if the participant did not leave any message, did so at an incorrect time (≥15% of the target time; i.e., ±3 hours and 35 minutes), or left a message without specifying the number of hours slept. Prior research supports the reliability (Woods, Moran, et al., 2008) and construct validity (Woods et al., 2009; Woods, Iudicello, et al., 2008, Gupta et al., 2010) of the MIST, including the time-based scale and 24-hour trial (Carey et al., 2006; Zogg et al., 2010) in HIV infection. "
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    ABSTRACT: The age-prospective memory (PM) paradox asserts that, despite evidence of age-associated PM deficits on laboratory tasks, older adults perform comparably to (or better than) young adults on naturalistic PM tasks. This study examined the age-PM paradox in older HIV-infected individuals, who represent a growing epidemic and may be at heightened risk for adverse neurocognitive and everyday functioning outcomes. Participants included 88 older (50+ years) and 53 younger (≤40 years) HIV-infected individuals as well as 54 older and 59 younger seronegative adults who completed both laboratory and naturalistic time-based PM tasks. Similar interactions were observed in both the seropositive and the seronegative samples, such that the older participants demonstrated significantly lower laboratory-based PM than the younger groups, but not on the naturalistic PM trial. Secondary analyses within the HIV+ sample revealed that naturalistic task success was indirectly associated with greater self-reported use of PM-based and external compensatory strategies in the daily lives of older, but not younger, HIV+ adults. Study findings suggest that, although older HIV-infected adults exhibit moderate PM deficits on laboratory measures versus their younger counterparts, such impairments are paradoxically not evident on ecologically relevant naturalistic PM activities in daily life, perhaps related to effective utilization compensatory strategies.
    Journal of Clinical and Experimental Neuropsychology 12/2011; 33(10):1108-18. DOI:10.1080/13803395.2011.604027 · 2.08 Impact Factor
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