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Publication Abstract Display
Type: Poster
Title: Lower cognitive reserve among individuals with syndromic HIV-associated neurocognitive disorders (HAND).
Authors: Morgan EE, Woods SP, Smith C, Weber E, Scott JC, Grant I, and the HNRC Group
Date: 02-15-2012
Abstract:Objective: The cognitive reserve model states that the critical threshold at which brain pathology manifests as cognitive deficits differs on an individual basis as a function of the capacity for efficiently engaging brain networks. HIV-seropositive individuals with low cognitive reserve are more likely to be cognitively impaired than their counterparts with high reserve, and therefore it was hypothesized that cognitive reserve would also differentiate cognitively impaired HIV-seropositive individuals (i.e., those with HIVassociated neurocognitive disorders, or HAND) with and without everyday functioning decline (i.e., syndromic versus subsyndromic diagnoses). Methods: Eighty-six individuals with HIV infection were evaluated; 53 individuals evidenced normal neurocognitive performance, 16 had subsyndromic HAND (SubHAND), and 17 were diagnosed with a syndromic HAND (SynHAND) based on a comprehensive neuropsychological battery that included both self-report and objective functional assessments. Cognitive reserve represented a combined score including years of education, estimated verbal IQ, and highest occupational attainment. Results: The groups were comparable with regard to demographic, psychiatric, and medical factors, and the HAND groups had comparable levels of global neurocognitive impairment. An ANOVA revealed significant groups differences (p = .008, ηp 2 = 0.109), and the SynHAND group had lower reserve scores relative to subjects with either normal cognition (p = .002, Cohenís d = 0.89) or SubHAND (p = .02, Cohenís d = 0.73). Conclusions: Extending the cognitive reserve model to everyday functioning, these data suggest that individuals with higher reserve more effectively compensate for cognitive impairment through better ability to use brain networks and strategies to maintain independence in daily living activities.

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