A 2-year longitudinal randomized controlled trial examining the transfer of speed of processing training to secondary cognitive domains in middle-aged and older adults with HIV-associated neurocognitive disorder: Results of the think fast study

Abstract

Objective: As people with HIV (PWH) age, they are at-risk of developing cognitive impairments compared to their seronegative counterparts. Although speed of processing (SOP) training may help improve this cognitive ability, less work has examined transfer to other cognitive domains. This study examined the effect of SOP training has on secondary cognitive domains in PWH aged 40+ years. Method: In this 3-group 2-year longitudinal study, 216 PWH with HIV-associated neurocognitive disorder (HAND) or borderline HAND were randomized to either: (1) 10 h of SOP training (n = 70); (2) 20 h of SOP training (n = 73); or (3) 10 h of an active control training (n = 73). Participants completed a comprehensive cognitive battery at baseline, immediately after training, and at 1 and 2 years. This battery yielded global and domain specific T-scores as well as a cognitive impairment variable. Generalized linear mixed-effect models were fitted to estimate between-group mean differences at the follow-up time-points adjusted for baseline. Results: No clinically or statistically significant improvements in any of the cognitive outcomes were observed. A sensitivity analysis was conducted; conclusions replicated those of the main analysis, with two exceptions: Global Function T and Psychomotor Speed T showed relevant training improvements among the intervention groups over the control group at the immediate post time point. Conclusions: Although SOP training has been shown to improve cognitive abilities that correspond to driving and mobility, such training has limited therapeutic utility in improving cognition in other domains in PWH with HAND.

Keywords:

• Brain fitness
• cognitive reserve
• cognitive training
• HIV-Associated neurocognitive disorder
• neuroplasticity
• speed of processing

Disclosure statement

No potential conflict of interest was reported by the authors.

Informed consent

Consent to participate: Informed consent was obtained from all individual participants included in the study. Consent to publish: Participants consented that their data would be used in aggregate form for publication purposes.

Research involving human participants and/or animals

Written informed consent was obtained using procedures approved by the investigational review board at each of the collaborating institutions. All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Additional information

Funding

The contents of this publication are solely the responsibility of the authors and do not represent the official views of the National Institutes of Health (NIH). The following funding is acknowledged: NIH/National Institute of Mental Health R01-award (1R01MH106366-01A1; ClinicalTrials.gov; NCT02758093; PI: Vance) titled ‘‘An RCT of Speed of Processing Training in Middle-aged and Older Adults with HIV’’; NIH/National Institute on Aging (NIA) R00-award (R00 AG048762; PI: Fazeli), ORWH and NIH/NIDA BIRCWH grant (5K12DA035150; PI: Curry with Pope); NIH/NIA P30-award (Edward R. Roybal Center for Translational Research in Aging and Mobility; P30 AG022838; PI: Ball). Karlene Ball has a commercial interest in the UFOV test used in this study.