Correlates of subjective and objective everyday functioning in middle-aged and older adults with human immunodeficiency virus

Abstract

People with human immunodeficiency virus (HIV) (PWH) are at an increased risk for impaired everyday functioning and they may also experience poor awareness of their functional status. This study identified factors associated with (1) subjective and objective instrumental activities of daily living (IADLs) and (2) awareness of functional capacity in PWH. In this cross-sectional study, 236 PWH completed a neurobehavioral assessment, including self-report and performance-based measures of IADLs. Multiple regressions were performed to identify demographic, personality, and cognitive factors contributing to subjective and objective evaluation of everyday functioning, as well as discrepancy between self-report and performance-based measures of IADLs. Results indicated that increased depression was associated with worsened self-report of everyday functioning but not performance of IADLs. Cognitive function and age were associated with IADL performance. Most participants (58.1%) demonstrated a discrepancy between self-report and actual performance of IADLs. Worse processing speed was correlated with greater discrepancy. Inaccurate self-reporters had worse overall cognitive functioning and lower levels of personality traits, including openness, conscientiousness, and agreeableness. In conclusion, self-report and actual performance of IADLs in PWH is influenced by different factors. Self-report may be more affected by psychological variables, such as mood and personality, while actual performance is more sensitive to age and cognitive function.

Keywords:

• Cognition
• everyday functioning
• personality
• HIV
• instrumental activities of daily living

Ethical approval

This study used written consent for all study procedures and the parent study was approved by the University of Alabama at Birmingham Institutional Review Board.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

Raw data were generated at University of Alabama at Birmingham. Due to the nature of this research, participants of this study did not agree for their data to be shared publicly, so supporting data is not available.

Additional information

Funding

This work was supported by the NIN/NINR under Grant (1R21NR016632-01; ClinicalTrials.gov [NCT03122288]; Vance, Principal Investigator) titled “Individualized-Targeted Cognitive Training in Older Adults with HAND”, by an NIH/NIMH R01-award [1R01MH106366-01A1; ClinicalTrials.gov [NCT02758093]; Vance, Principal Investigator) titled “An RCT of Speed of Processing Training in Middle-aged and Older Adults with HIV”), and by an NIH/NIA P30-award (Edward R. Roybal Center for Translational Research in Aging and Mobility; P30 AG022838; PI: Ball).