The semantic relatedness of cue–intention pairings influences event-based prospective memory failures in older adults with HIV infection

Abstract

HIV infection and aging are each independently associated with prospective memory (ProM) impairment, which increases the risk of poor functional outcomes, including medication non-adherence. The incidence and prevalence of HIV infection among older adults has increased in recent years, thereby raising questions about the combined effects of these risk factors on ProM. In the present study, 118 participants were classified into four groups on the basis of HIV serostatus and age (i.e., ≤40 years and ≥50 years). Results showed significant additive effects of HIV and aging on event-based ProM, with the greatest deficits evident in the older HIV+ group, even after controlling for other demographic factors and potential medical and psychiatric confounds. Event-based ProM impairment was particularly apparent in the older HIV+ group on trials for which the retrieval cue and intention were not semantically related. Worse performance on the semantically unrelated cue–intention trials was associated with executive dysfunction, older age, and histories of immunocompromise in the older HIV+ cohort. These data suggest that older HIV-infected adults are significantly less proficient at engaging the strategic encoding and retrieval processes required to a execute a future intention when the cue is unrelated to the intended action, perhaps secondary to greater neuropathological burden in the prefrontostriatal systems critical to optimal ProM functioning.

Keywords:

• Human Immunodeficiency Virus
• Episodic memory
• Aging
• AIDS dementia complex
• Multiprocess theory

The HIV Neurobehavioral Research Center (HNRC) Group is affiliated with the University of California, San Diego, the Naval Hospital, San Diego, and the Veterans Affairs San Diego Healthcare System and includes: Director: Igor Grant, MD; Codirectors: J. Hampton Atkinson, MD, Ronald J. Ellis, MD, PhD, and J. Allen McCutchan, MD; Center Manager: Thomas D. Marcotte, PhD; Naval Hospital San Diego: Braden R. Hale, MD, MPH (PI); Neuromedical component: Ronald J. Ellis, MD, PhD (PI), J. Allen McCutchan, MD, Scott Letendre, MD, Edmund Capparelli, PharmD, Rachel Schrier, PhD; Neurobehavioral component: Robert K. Heaton, PhD (PI), Mariana Cherner, PhD, David J. Moore, PhD, Steven Paul Woods, PsyD; Neuroimaging component: Terry Jernigan, PhD (PI), Christine Fennema-Notestine, PhD, Sarah L. Archibald, MA, John Hesselink, MD, Jacopo Annese, PhD, Michael J. Taylor, PhD; Neurobiology component: Eliezer Masliah, MD (PI), Ian Everall, FRCPsych, FRCPath, PhD, T. Dianne Langford, PhD; Neurovirology component: Douglas Richman, MD (PI), David M. Smith, MD; International component: J. Allen McCutchan, MD (PI); Developmental component: Ian Everall, FRCPsych, FRCPath, PhD (PI), Stuart Lipton, MD, PhD; Clinical trials component: J. Allen McCutchan, MD, J. Hampton Atkinson, MD, Ronald J. Ellis, MD, PhD, Scott Letendre, MD; Participant Accrual and Retention Unit: J. Hampton Atkinson, MD (PI), Rodney von Jaeger, MPH; Data Management Unit: Anthony C. Gamst, PhD (PI), Clint Cushman, BA (Data Systems Manager), Daniel R. Masys, MD (Senior Consultant); Statistics Unit: Ian Abramson, PhD (PI), Christopher Ake, PhD, Florin Vaida, PhD.

This research was supported by National Institute of Mental Health Grants R01-MH073419 to S. P. Woods and P30-MH62512 to I. Grant. The views expressed in this article are those of the authors and do not reflect the official policy or position of the Department of the Navy, the Department of Defense, or the United States Government. The authors thank Catherine L. Carey, Lisa Moran, Marizela Cameron, Ofilio Vigil, and Sarah Gibson for their help with study management, Chris Ake for his assistance with statistical analyses, and Sarah Raskin for providing us with the Memory for Intentions Screening Test (MIST) and the Abbreviated Assessment of Intentional Memory (AAIM).