| Publication Abstract Display | | Type: Published Abstract | | Title: Metacognition partially mediates the relationship between neurocognitive and everyday functioning among older adults with HIV. | | Authors: Casaletto K, Fazeli P, Woods S, Moore D, and the HNRP Group | | Year: 2015 | | Publication: 43rd Annual Meeting of the International Neuropsychological Society | | Volume: Issue: Pages: | | Abstract:Objective: Although it is well established that neurocognitive impairment is associated with poorer everyday functioning outcomes (e.g., medication management), factors that mediate this relationship are not well understood. Poor metacognition (awareness of neurocognitive abilities) is associated with greater errors in everyday life and may represent one such factor. Our study assessed the role of metacognition as a mediator between neurocognitive impairment and everyday functioning among older adults with HIV disease.
Participants and Methods: 100 older (≥50 years) HIV+ participants completed a performance-based daily functioning task, which assessed four living skills (e.g., medication and financial management), alongside a comprehensive neuropsychological battery. Participants were also queried regarding their global metacognition of their daily task performance, which included metacognitive knowledge (self- and task-knowledge) and online awareness (task appraisal, self-monitoring, and self-evaluation).
Results: Using bootstrapping methods, global metacognition emerged as a partial mediator between neurocognition and everyday task performances (95%CI: 0.01, 0.26). Specifically, metacognitive knowledge (95%CI: 0.02, 0.22), but not online awareness (95%CI: -0.02, 0.12) partially mediated the relationship between neurocognition and everyday functioning. Within metacognitive knowledge, self-knowledge (95%CI: 0.12, 0.17) appeared to be driving the mediation more than task-knowledge (95%CI: -0.01, 0.11).
Conclusions: Among older HIV+ participants, insight into one’s functioning is one mechanism by which neurocognitive impairment results in poorer daily functioning. In particular, self-knowledge, which included ratings of self-efficacy and self-predictions, emerged as an important pathway by which neurocognition influences successful everyday functioning. As such, developing targeted interventions to enhance metacognition among HIV+ older adults may help to remediate everyday functioning impairment in this vulnerable population. |
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