An examination of the age-prospective memory paradox in HIV-infected adults

Abstract

The age-prospective memory (PM) paradox asserts that, despite evidence of age-associated PM deficits on laboratory tasks, older adults perform comparably to (or better than) young adults on naturalistic PM tasks. This study examined the age-PM paradox in older HIV-infected individuals, who represent a growing epidemic and may be at heightened risk for adverse neurocognitive and everyday functioning outcomes. Participants included 88 older (50+ years) and 53 younger (≤40 years) HIV-infected individuals as well as 54 older and 59 younger seronegative adults who completed both laboratory and naturalistic time-based PM tasks. Similar interactions were observed in both the seropositive and the seronegative samples, such that the older participants demonstrated significantly lower laboratory-based PM than the younger groups, but not on the naturalistic PM trial. Secondary analyses within the HIV+ sample revealed that naturalistic task success was indirectly associated with greater self-reported use of PM-based and external compensatory strategies in the daily lives of older, but not younger, HIV+ adults. Study findings suggest that, although older HIV-infected adults exhibit moderate PM deficits on laboratory measures versus their younger counterparts, such impairments are paradoxically not evident on ecologically relevant naturalistic PM activities in daily life, perhaps related to effective utilization compensatory strategies.

Keywords:

• Episodic memory
• Aging
• Neuropsychological assessment
• AIDS dementia complex
• Cognition

Acknowledgments

The San Diego 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; Co-Directors: J. Hampton Atkinson, Ronald J. Ellis, and J. Allen McCutchan; Center Manager: Thomas D. Marcotte; Jennifer Marquie-Beck; Melanie Sherman; Neuromedical Component: Ronald J. Ellis (P.I.), J. Allen McCutchan, Scott Letendre, Edmund Capparelli, Rachel Schrier, Terry Alexander, Debra Rosario, Shannon LeBlanc; Neurobehavioral Component: Robert K. Heaton (P.I.), Steven Paul Woods, Mariana Cherner, David J. Moore, Matthew Dawson; 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.), Cristian Achim, Ian Everall (Consultant); Neurovirology Component: Douglas Richman (P.I.), David M. Smith; International Component: J. Allen McCutchan (P.I.); Developmental Component: Cristian Achim (P.I.); Stuart Lipton; 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); Statistics Unit: Ian Abramson (P.I.), Florin Vaida, Reena Deutsch, Anya Umlauf, Tanya Wolfson. This research was supported by National Institute of Mental Health Grants R01–MH073419 to Steven Paul Woods and P30–MH62512 to Igor 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, Department of Defense, or the United States Government. Aspects of these data were presented at the 3rd International Conference on Prospective Memory in Vancouver, British Columbia, Canada. The authors thank Catherine L. Carey, Matthew Dawson, Lisa Moran, Ofilio Vigil, Sarah Gibson, and Patricia Riggs for their help with study management.