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Prospective Memory in HIV-1 Infection

出版	University of California, San Diego and San Diego State University, 2005
URL	http://books.google.com.hk/books?id=9RURAQFS_JcC&hl=&source=gbs_api

註釋Approximately 30-50% of individuals infected with HIV-1 exhibit neuropsychological (NP) impairment, which is associated with neuropathology preferentially affecting the fronto-striato-thalamo-cortical circuits. Specifically, a frontal-subcortical pattern of encoding and retrieval deficits is evident on tests of retrospective episodic memory (i.e., recalling past information). Importantly, such deficits have been linked to problems performing instrumental activities of daily living (IADLs), in particular, medication adherence. One episodic memory construct, ubiquitous in everyday life, but not yet examined in HIV-1, is prospective memory (ProM), which involves the complex processes of forming, monitoring, and executing future intentions vis-à-vis ongoing distractions. The current study examined ProM in 42 HIV-1-infected participants (HIV+) and 29 demographically comparable healthy controls (HC). Results showed that the HIV+ group demonstrated poorer ProM functioning than HC (Cohen's d = −0.92). The HIV+ group exhibited deficits in both time and event based ProM, committed more 24-hour delay ProM failures, and were more likely to make ProM task substitution errors than HC. No group differences were observed on the recognition trial, indicating HIV+ individuals accurately retained and recognized ProM intentions when provided a structured format that minimized retrieval demands. Within the HIV+ sample, IADL dependent individuals demonstrated poorer ProM than IADL independent participants (Cohen's d = −1.25) but comparable retrospective memory (Cohen's d range = −0.17 to −0.37). Finally, significant correlations between ProM and measures of executive functioning, learning, verbal working memory, and information processing speed were found within HIV+ and HC samples (Spearman's rho's ranged from 0.32 to 0.58), providing preliminary evidence for convergent validity. The divergent validity of ProM was demonstrated by non-significant correlations with semantic memory, memory savings scores (i.e., retention), and recognition discrimination. Taken together, these data indicate that HIV-1 infection is associated with ProM impairment that is characterized by a breakdown in the strategic (i.e., executive) aspects of prospective encoding and retrieval. In sum, these findings support the construct validity of ProM, the assessment of which may inform evaluations of and interventions related to HIV-associated neurocognitive disorders.