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Exergaming in Older People Living with HIV Improves Balance, Mobility and Ameliorates Some Aspects of Frailty
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Impairments of Motor Function While Multitasking in HIV.

Sharif I Kronemer1,2, Jordan A Mandel1, Ned C Sacktor1

  • 1Department of Neurology, Johns Hopkins School of MedicineBaltimore, MD, USA.

Frontiers in Human Neuroscience
|May 16, 2017
PubMed
Summary
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Multitasking assessments reveal hidden motor impairments in individuals with Human Immunodeficiency Virus (HIV), even when standard tests show normal function. This approach enhances the detection of HIV-associated neurocognitive disorders (HAND).

Area of Science:

  • Neuroscience
  • Immunology
  • Psychology

Background:

  • Combination antiretroviral therapy (CART) has transformed Human Immunodeficiency Virus (HIV) into a manageable chronic condition.
  • Long-term HIV infection is associated with neurocognitive impairments, categorized as HIV-associated neurocognitive disorders (HAND).
  • Current assessments may not fully capture the complexities of cognitive and motor deficits in individuals living with HIV.

Purpose of the Study:

  • To investigate cognitive and motor impairments in individuals with HIV using a novel multitasking paradigm.
  • To assess the real-world validity of multitasking assessments in mimicking daily dual-task demands.
  • To identify if multitasking can reveal subtle impairments missed by standard single-task assessments.

Main Methods:

Keywords:
HIVHIV-associated neurocognitive disorders (HAND)cognitionmotormultitaskingworking memory

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  • Participants with HIV performed a novel multitasking task simulating real-world dual motor and cognitive demands.
  • Cognitive performance (working memory recall) and motor function were assessed during the multitasking paradigm.
  • Results were compared to standard cognitive and motor assessments and HAND staging.

    • Main Results:

    • Individuals with HIV demonstrated significant impairment in the motor component of the multitasking task.
    • Cognitive performance, specifically working memory recall, was generally spared during multitasking.
    • A positive correlation between motor performance and working memory recall was observed in poorer-performing HIV+ individuals.
    • Multitask performance did not correlate with the stage of HAND, and standard tests indicated normal motor function in some impaired participants.

    Conclusions:

    • Multitasking assessments are more sensitive than standard tests in detecting motor impairments in individuals with chronic HIV.
    • This novel approach can uncover hidden deficits and improve the sensitivity of clinical assessments for HAND staging.
    • Future research should explore the predictive value of multitasking tasks for real-world functioning and prognosis in patients with chronic HIV.