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Lower Cognitive Reserve Among Individuals with Syndromic HIV-Associated Neurocognitive Disorders (HAND)

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Abstract

HIV-seropositive individuals with low cognitive reserve are at high risk for developing HIV-associated neurocognitive disorders (HAND). The present study evaluated the hypothesis that cognitive reserve would also play a unique role in the expression of everyday functioning complications among those with HAND (i.e., syndromic versus subsyndromic impairment). Eighty-six individuals with HIV infection were evaluated; 53 individuals evidenced normal neurocognitive performance, 16 had subsyndromic HAND (i.e., asymptomatic neurocognitive impairment), and 17 were diagnosed with syndromic HAND based on a comprehensive neurobehavioral evaluation. Cognitive reserve represented a combined score including years of education, estimated verbal IQ, and highest occupational attainment. The groups were comparable (e.g. demographics), and the HAND groups had similar rates of global neurocognitive impairment. The syndromic HAND group evidenced lower reserve scores relative to both other groups, suggesting that individuals with lower reserve may be less able to effectively counteract their neurocognitive impairment to maintain independence in daily living activities than HIV-infected individuals with high cognitive reserve.

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Acknowledgments

This research was supported by National Institute of Health grants 2R01MH073419, 1T32DA031098, T32AA013525, and P30MH62512. The HIV Neurobehavioral Research Program (HNRP) Group is affiliated with Veterans Affairs San Diego Healthcare System, and includes: Director: Igor Grant, M.D.; Co-Directors: J. Hampton Atkinson, M.D., Ronald J. Ellis, M.D., Ph.D., and J. Allen McCutchan, M.D.; Center Manager: Thomas D. Marcotte, Ph.D.; Jennifer Marquie-Beck, M.P.H.; Melanie Sherman; Neuromedical Component: Ronald J. Ellis,. M.D., Ph.D. (P.I.), J. Allen McCutchan, M.D., Scott Letendre, M.D., Edmund Capparelli, Pharm.D., Rachel Schrier, Ph.D., Terry Alexander, R.N., Debra Rosario, M.P.H., Shannon LeBlanc; Neurobehavioral Component: Robert K. Heaton, Ph.D. (P.I.), Steven Paul Woods, Psy.D., Mariana Cherner, Ph.D., David J. Moore, Ph.D., Matthew Dawson; Neuroimaging Component: Terry Jernigan, Ph.D. (P.I.), Christine Fennema-Notestine, Ph.D., Sarah L. Archibald, M.A., John Hesselink, M.D., Jacopo Annese, Ph.D., Michael J. Taylor, Ph.D.; Neurobiology Component: Eliezer Masliah, M.D. (P.I.), Cristian Achim, M.D., Ph.D., Ian Everall, FRCPsych., FRCPath., Ph.D. (Consultant); Neurovirology Component: Douglas Richman, M.D., (P.I.), David M. Smith, M.D.; International Component: J. Allen McCutchan, M.D., (P.I.); Developmental Component: Cristian Achim, M.D., Ph.D.; (P.I.), Stuart Lipton, M.D., Ph.D.; Participant Accrual and Retention Unit: J. Hampton Atkinson, M.D. (P.I.), Rodney von Jaeger, M.P.H.; Data Management Unit: Anthony C. Gamst, Ph.D. (P.I.), Clint Cushman (Data Systems Manager); Statistics Unit: Ian Abramson, Ph.D. (P.I.), Florin Vaida, Ph.D., Reena Deutsch, Ph.D., Anya Umlauf, M.S., Tanya Wolfson, M.A. The views expressed in this article are those of the authors and do not reflect the official policy or position of the Department of the Navy, Department of Defense, nor the United States Government. The authors report no conflicts of interest for this study. We thank Dr. Catherine L. Carey, Lisa Moran, Matthew Dawson, Ofilio Vigil, Sarah Gibson, Marizela Cameron, and P. Katie Riggs for their help with study management.

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Authors and Affiliations

  1. Department of Psychiatry, University of California, 220 Dickinson St., Suite B, San Diego, CA, 92103, USA

    Erin E. Morgan, Steven Paul Woods, Christine Smith & Igor Grant

  2. Department of Psychology, University of Denver, Denver, CO, USA

    Christine Smith

  3. SDSD/UCSD Joint Doctoral Program, San Diego, CA, USA

    Erica Weber

  4. Department of Psychiatry, Yale University, New Haven, CT, USA

    J. Cobb Scott

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  1. Erin E. Morgan
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  2. Steven Paul Woods
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  3. Christine Smith
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  4. Erica Weber
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  5. J. Cobb Scott
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  6. Igor Grant
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The HIV Neurobehavioral Research Program (HNRP) Group

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Correspondence to Erin E. Morgan.

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Morgan, E.E., Woods, S.P., Smith, C. et al. Lower Cognitive Reserve Among Individuals with Syndromic HIV-Associated Neurocognitive Disorders (HAND). AIDS Behav 16, 2279–2285 (2012). https://doi.org/10.1007/s10461-012-0229-7

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