| 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, Cohen’s d = 0.89) or SubHAND (p = .02, Cohen’s 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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