Functional disability in medication management and driving among individuals with HIV: A 1-year follow-up study

Abstract

Approximately 50% of individuals with HIV report cognitive deficits that can affect social or occupational functioning. The present study used a longitudinal design (1 year) to examine the relationship between cognitive factors and incidental functional deficits in medication management and driving ability among a cohort of 101 HIV+ participants. Participants were classified into groups of functionally “stable” and “disabled” for each laboratory-based functional task (i.e., Medication Management Task–Revised, MMT–R, and PC-based driving simulator). We hypothesized that participants who exhibited a functional deficit in either MMT–R or driving at follow-up assessment would demonstrate significantly poorer baseline cognitive performance at study entry than participants who remained functionally stable. As hypothesized, participants who demonstrated significantly lower baseline performance in learning/memory and executive functioning also demonstrated functional disability on the MMT–R at follow-up when compared to functionally stable participants. Poor baseline performance in speed of information processing was associated with a deficit in driving ability at follow-up assessment. Our results suggest that lower baseline cognitive functioning predicts downstream functional disability, and that deficits in learning/memory and information processing speed are particularly predictive of deficits in medication management and driving ability.

Keywords:

• HIV
• Instrumental activities of daily living
• Cognitive function
• Medication management
• Driving

Acknowledgments

We would like to acknowledge the following funding sources: VA Merit Review awarded to Charles Hinkin, PhD and National Institute of Mental Health training grant (T32 19535; PI: C. Hinkin).