Publication Abstract Display
Type: Poster
Title: Neurocognition and protective factors in HIV: Implications for cognitive reserve.
Authors: Fazeli PL, Gouaux B, Rosario D, Heaton R, Moore D, and the HNRP Group
Date: 10-16-2013
Abstract:Objective: Studies of healthy adults show a relationship between engagement in mental, physical, and social activities and better cognitive outcomes, suggesting these activities may increase cognitive reserve, or the threshold of neurological insults one can withstand before manifestation of cognitive impairment. Given that individuals with HIV have a higher prevalence of risk factors to cognitive impairment, the present study examined the potential protective effect of physical exercise, employment, and social activity on cognitive performance among HIV+ adults. Method: HIV+ (N=174) participants completed a neuromedical and neuropsychological battery. Participants were classified on a summative scale of protective factors (0 to 3) based on physical exercise, social engagement, and current employment. ANCOVA was used to examine differences on demographically-adjusted neuropsychological T-scores between the four protective factor classification groups after adjusting for age, education, mood, current and nadir CD4 counts. Results: A stair-step effect across the groups was observed, such that an increasing number of protective factors was associated with better overall neuropsychological performance (p < 0.001). There were no significant covariates, although current CD4 (p = 0.07), nadir CD4 (p = 0.06), and BDI (p = 0.09) approached significance. Conclusions: These findings demonstrate only cross-sectional associations, but support the cognitive reserve hypothesis of the protective effect of mental, physical, and social activities on expression of underlying neuropathology among HIV+ persons. Future studies should utilize longitudinal observational or intervention approaches to establish cause-effect relationships and uncover the diverse neural mechanisms whereby physical, mental, and social stimulation may protect cognition.

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