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Functional disability in medication management and driving among individuals with HIV: a 1-year follow-up study

April D Thames1, Alyssa Arentoft, Monica Rivera-Mindt

  • 1Department of Psychiatry and Biobehavioral Sciences, UCLA School of Medicine, Los Angeles, CA 90095, USA. athames@mednet.ucla.edu

Journal of Clinical and Experimental Neuropsychology
|December 15, 2012
PubMed

Insights

Cognitive deficits in people with HIV (Human Immunodeficiency Virus) can predict future challenges with daily tasks. Lower baseline learning, memory, and executive function are linked to medication management difficulties.

Area of Science:

  • Neuropsychology
  • Infectious Diseases
  • Gerontology

Background:

  • Cognitive deficits are prevalent in approximately 50% of individuals with HIV.
  • These deficits can significantly impair social and occupational functioning.
  • Understanding the link between cognition and daily function is crucial for intervention.

Purpose of the Study:

  • To longitudinally examine the relationship between cognitive factors and functional deficits in medication management and driving ability in HIV+ individuals.
  • To determine if baseline cognitive performance predicts later functional disability.
  • To identify specific cognitive domains most predictive of functional decline.

Main Methods:

  • A 1-year longitudinal study of 101 HIV+ participants.
  • Assessment of cognitive functions including learning/memory, executive functioning, and information processing speed.
  • Laboratory-based functional tasks: Medication Management Task-Revised (MMT-R) and a PC-based driving simulator.
  • Classification of participants into functionally
  • stable
  • and
  • disabled
  • groups for each task.

Main Results:

  • Lower baseline performance in learning/memory and executive functioning predicted functional disability in medication management at follow-up.
  • Poor baseline speed of information processing was associated with deficits in driving ability at follow-up.
  • Cognitive decline at baseline significantly predicted downstream functional disability.

Conclusions:

  • Baseline cognitive functioning is a significant predictor of future functional disability in individuals with HIV.
  • Deficits in learning/memory and information processing speed are particularly indicative of challenges in medication management and driving.
  • These findings highlight the importance of cognitive screening for functional assessment in HIV care.

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