Is prospective memory a dissociable cognitive function in HIV infection?

Abstract

An emerging literature indicates that HIV infection is associated with deficits in prospective memory (ProM), or the ability to execute a future intention. This literature offers evidence of neurobiological dissociability of ProM from other cognitive abilities and its incremental ecological validity as a predictor of poorer everyday functioning outcomes (e.g., medication nonadherence). The present study evaluated the hypothesis that ProM represents a unique cognitive construct in HIV disease. A confirmatory 4-factor structural equation model was tested on data derived from 162 participants with HIV. The model posited that measures of ProM comprise a unique factor, apart from standard clinical tests of retrospective memory, executive functions, and motor skills. The fit of the model was evaluated using the Bollen–Stine bootstrap method and indicated that a 4-factor model with measures of ProM loading on a unique factor fit the data well, and better than a model with a single common factor hypothesized to drive cognitive performance. The results of this study lend further evidence to the dissociability of ProM in HIV infection, are consistent with prior studies in healthy adults, and contribute to a growing literature on the construct validity of ProM in HIV disease.

Keywords:

• Human immunodeficiency virus
• AIDS dementia complex
• Neuropsychological tests
• Cognitive science
• Episodic memory

This research was supported by Grants MH073419 and MH62512 from the National Institute of Mental Health. 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, Department of Defense, or the United States Government. Aspects of these data were presented at the Annual Convention of the American Psychological Association in Toronto, Ontario, Canada. The authors of this manuscript wish to acknowledge the contributions of Reena Deutsch, Christopher Ake, and Terence J. G. Tracey for their review of this work during its development and their methodological guidance.

Notes

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; Codirectors: J. Hampton Atkinson, Ronald J. Ellis, and J. Allen McCutchan; Center Manager: Thomas D. Marcotte; Naval Hospital San Diego: Braden R. Hale (P.I.); Neuromedical Component: Ronald J. Ellis (P.I.), J. Allen McCutchan, Scott Letendre, Edmund Capparelli, Rachel Schrier; Neurobehavioral Component: Robert K. Heaton, Mariana Cherner, Syrus Gupta, David J. Moore, Steven Paul Woods; Neuroimaging Component: Terry Jernigan (P.I.), Christine Fennema-Notestine, Sarah L. Archibald, John Hesselink, Jacopo Annese, Michael J. Taylor; Neurobiology Component: Eliezer Masliah (P.I.), Ian Everall, T. Dianne Langford; Neurovirology Component: Douglas Richman (P.I.), David M. Smith; International Component: J. Allen McCutchan (P.I.); Developmental Component: Ian Everall (P.I.), Stuart Lipton; Clinical Trials Component: J. Allen McCutchan, J. Hampton Atkinson, Ronald J. Ellis, Scott Letendre; Participant Accrual and Retention Unit: J. Hampton Atkinson (P.I.), Rodney von Jaeger; Data Management Unit: Anthony C. Gamst (P.I.), Clint Cushman (Data Systems Manager), Daniel R. Masys (Senior Consultant); Statistics Unit: Ian Abramson (P.I.), Christopher Ake, Florin Vaida.