The Role of Employment on Neurocognitive Reserve in Adults With HIV: A Review of the Literature

Abstract

The benefits of employment are enormous; being employed, one naturally: 1) socially engages with the public and colleagues/co-workers; 2) learns new skills to increase job productivity and competence; 3) establishes a routine that can prevent lethargy and boredom and may regulate sleep and healthy behaviors; 4) is provided purposeful and meaningful activity that may protect one from depression; and 5) gains income to pursue interests which are cognitively stimulating. All of these and other employment influences can provide an enriched personal and social environment that stimulates positive neuroplasticity and promotes neurocognitive reserve. Such potential neurocognitive benefits are particularly relevant to adults with HIV for two reasons: 1) approximately 50% of adults with HIV experience observable cognitive impairments that can adversely affect everyday functioning such as medication adherence, and 2) approximately 45% of adults with HIV are unemployed and do not receive the neurocognitive benefits of employment. From these considerations, implications for healthcare research and nursing practice are provided.

Aging and Neurocognitive Functioning in HIV-Infected Women: a Review of the Literature Involving the Women’s Interagency HIV Study

“…Cognitive reserve may be supported by healthy behaviors such as physical exercise or good nutrition that simply promotes general health which benefits brain health. 8,9 On the contrary, cognitive reserve may be unsupported by unhealthy behaviors such as drug use, stress, and a sedentary lifestyle. 10–13 Several studies have shown that in normal older adults, 14 as well as HIV-infected adults, 10 active engagement facilitates increased cognitive reserve and successful cognitive aging.…”

Physical Activity and Cognitive Function in Older Adults: The Mediating Effect of Depressive Symptoms

“…There are several factors that can encourage positive neuroplasticity which is necessary to support cognitive reserve; these include physical activity, good mood support, stimulating and mentally challenging activities, and social interaction. In fact, even employment and volunteer work has been suggested recently as being an important vector for maintaining optimal cognitive functioning as people age (Vance, Cody, Yoo-Jeong, Jones, & Nicholson, 2015). Likewise, there are several factors that likewise promote negative neuroplasticity and reduce cognitive reserve, thus making people more vulnerable for age-related cognitive declines; these include depression and anxiety, loneliness, poor health, substance abuse, and lacking stimulating activities.…”

The impact of employment on cognition and cognitive reserve: implications across diseases and aging

“…Based upon the literature, Vance et al described five mechanisms in which employment supports cognitive reserve: 1) learning new skills; 2) social engagement; 3) established routine/structure; 4) purpose/meaning; and 5) income (Figure 1). 12 …”