Lower prospective memory is associated with higher neurocognitive dispersion in two samples of people with HIV: A conceptual replication study

Abstract

Objectives: People living with HIV (PLWH) often experience deficits in the strategic/executive aspects of prospective memory (PM) that can interfere with instrumental activities of daily living. This study used a conceptual replication design to determine whether cognitive intraindividual variability, as measured by dispersion (IIV-dispersion), contributes to PM performance and symptoms among PLWH. Methods: Study 1 included 367 PLWH who completed a comprehensive clinical neuropsychological test battery, the Memory for Intentions Test (MIsT), and the Prospective and Retrospective Memory Questionnaire (PRMQ). Study 2 included 79 older PLWH who completed the Cogstate cognitive battery, the Cambridge Prospective Memory Test (CAMPROMPT), an experimental measure of time-based PM, and the PRMQ. In both studies, a mean-adjusted coefficient of variation was derived to measure IIV-dispersion using normative T-scores from the cognitive battery. Results: Higher IIV-dispersion was significantly associated with lower time-based PM performance at small-to-medium effect sizes in both studies (mean r s = −0.30). The relationship between IIV-dispersion and event-based PM performance was comparably small in magnitude in both studies (r s = −0.19, −0.20), but it was only statistically significant in Study 1. IIV-dispersion showed very small, nonsignificant relationships with self-reported PM symptoms in both samples (r s < 0.10). Conclusions: Extending prior work in healthy adults, these findings suggest that variability in performance across a cognitive battery contributes to laboratory-based PM accuracy, but not perceived PM symptoms, among PLWH. Future studies might examine whether daily fluctuations in cognition or other aspects of IIV (e.g., inconsistency) play a role in PM failures in everyday life.

Greater baseline intra-individual variation in telephone-based cognitive screening predicts cognitive and diagnostic outcomes at 2-year follow-up.

“…Clinical researchers have theorized that high IICV may be indicative of executive dysfunction. This hypothesis is supported by negative correlations between IICV and performances on executive functions (Mustafa et al, 2023; Sullivan et al, 2018).…”

Cognitive Intra-individual Variability in the Laboratory Is Associated With Greater Executive Dysfunction in the Daily Lives of Older Adults With HIV

“…A second limitation was our use of the relatively brief computerized Cogstate battery to measure cognitive IIV. Although prior studies provide some support for the usefulness of the Cogstate in this regard (e.g., Cho et al, 2023; Mustafa et al, 2023), future work may benefit from including well-validated standard clinical measures of EF such as continuous performance tasks. Third, our findings are restricted to the measurement of cognitive IIV by way of dispersion (i.e., score variability across a battery of tests), which may differ in meaningful ways to the assessment of cognitive IIV as measured by inconsistency across a single task (e.g., Rutter et al, 2020).…”

“…Among PWH, older adults (Morgan et al, 2011) and persons with substance use disorders (Arce Rentería et al, 2020) are at particular risk of higher cognitive IIV. Higher cognitive IIV across cognitive tests in PWH has been reliably associated with ecologically relevant abilities such as prospective memory (Mustafa et al, 2023) and daily tasks with significant EF demands. For instance, Morgan, Woods, et al (2012) reported that higher levels of cognitive IIV conferred a 1.6 higher risk of ADL dependence in PWH.…”

Stress and Right Prefrontal Transcranial Direct Current Stimulation (tDCS) Interactive Effects on Visual Working Memory and Learning

“…Cogstate is a computerized battery that was used to study diverse neuro-psychiatric disorders e.g., [31][32][33]. All Cogstate tasks utilize similar visual stimuli and general design; playing cards appear one at a time, face down, on the computer screen (inter-stimulus interval, ISI, ranges between 500 and 1500 ms).…”