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Planning deficits in HIV-associated neurocognitive disorders: component processes, cognitive correlates, and
Jordan E Cattie1, Katie Doyle, Erica Weber
1Joint Doctoral Program in Clinical Psychology, San Diego State University and University of California, San Diego, CA, USA.
Journal of Clinical and Experimental Neuropsychology
|June 27, 2012
Summary
Planning deficits are common in HIV-associated neurocognitive disorders (HAND). Impaired planning accuracy and rule adherence in HAND significantly impact daily living and employment, highlighting a critical area for intervention.
Area of Science:
- Neuroscience
- Psychology
- Infectious Diseases
Background:
- Executive dysfunction is a primary cognitive impairment in HIV-associated neurocognitive disorders (HAND).
- Planning, a key executive function, involves organizing sequential behaviors to achieve goals, but its specific deficits in HAND are understudied.
- Understanding planning impairments is crucial for addressing functional limitations in individuals with HAND.
Purpose of the Study:
- To investigate planning abilities in individuals with HAND using the Tower of London(DX).
- To examine the association between planning deficits and executive dysfunction within the HIV-positive population.
- To determine the clinical relevance of planning impairments on daily functioning and employment status in HIV.
Main Methods:
- The study included 53 individuals with HAND, 109 HIV-infected individuals without HAND, and 82 seronegative controls.
- The Tower of London(DX) test was administered to assess planning skills.
- Statistical analyses were performed to compare performance and identify predictors of functional decline.
Main Results:
- Individuals with HAND performed significantly worse on measures of planning accuracy, efficiency, and rule adherence compared to HIV-infected individuals without HAND.
- Within the HIV-positive group, higher total moves and rule violations correlated strongly with executive dysfunction.
- Elevated total moves and rule violations independently predicted self-reported declines in daily living activities and unemployment.
Conclusions:
- Planning accuracy, efficiency, and rule-bound control are demonstrably impaired in HAND.
- These planning deficits have significant, independent implications for instrumental activities of daily living and employment in people living with HIV.
- Targeting planning deficits may be essential for improving functional outcomes in HAND.
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