| Publication Abstract Display | | Type: Published Abstract | | Title: The functional impact of HIV-associated neuropsychological impairment: a longitudinal study. | | Authors: Heaton RK, Rivera Mindt M, Marcotte T, Moore DJ, Weinburg K, Grant I, and the HNRC Group | | Year: 2002 | | Publication: Journal of the International Neuropsychological Society | | Volume: 8 Issue: 2 Pages: 314-315 | | Abstract:Previous research indicates that HIV-associated neuropsychological (NP) impairment is associated with higher rates of unemployment, poorer vocational abilities, and increased dependence in activities of daily living (ADLs); however, the temporal nature of these relationships is unclear. In this study we assessed whether changes in NP status in HIV+ subjects were associated with changes in performance on laboratory based measures of ADLs and vocational functioning. Methods: 236 HIV+ subjects participated in a longitudinal study involving comprehensive neuromedical, NP, and functional status evaluations. Thirty-two individuals were classified as NP-improved and 32 as NP-declined across visits at least 6 months apart; these groups were equivalent on baseline NP and functional status. Results: At Time 2, NP decliners performed worse on measures of financial management ( p < .05) and medication management ( p < .10), as well as on a summary measure of overall functional ability ( p < .05). The groups were not significantly different on other individual functional measures at Time 2 (i.e., cooking, restaurant scenario, shopping, and vocational ability). Functionally impaired subjects had worse NP status and higher plasma HIV RNA viral load at both visits, but multiple regression analysis revealed that only initial NP status predicted functional impairment at Time 2. CD4 count and depression (Beck Depression Inventory) were not predictive of functional impairment at either time. Conclusions: Although preliminary, these findings suggest that both NP and neuromedical status are associated with objective evidence of functional impairment; however, NP status appears to be the most robust predictor of functional impairment over time. |
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