Marseille 2007
Marseille 2007
Abstract book
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Abstract #316  -  Cognitive reserve and cognitive impairment in a sample of HIV-infected patients
Session:
  42.2: Wellbeing and quality of life (Parallel) on Tuesday @ 16.30-18.30 in Auditorium/Overflow Chaired by Anna Liguori, Richard Harding
Authors:
  Presenting Author:   Prof Gordillo Victoria - University Complutense, Spain
 
  Additional Authors:  Prof Victoria Gordillo, Dr Juan Luis Snchez, Dr Juan Carro,  
Aim:
Different findings confirm the presence of cognitive and affective disorders in a substantial proportion of HIV-seropositive subjects, in different stages of the infection. Nevertheless, the concept of cognitive reserve (CR) suggests that innate intelligence or aspects of life experience like educational or occupational attainments may supply reserve, in the form of a set of skills or repertoires that allows some people to cope with progressing neurodegenerative diseases better than others. In consequence, the concept of cognitive reserve can provide a explanation for the fact that higher levels of educational and occupational attainment, or of intelligence, are good predictors of which individuals can sustain greater brain damage before demonstrating functional deficit. OBJECTIVE: To evaluate the influence of cognitive reserve on neuropsychological performance in patients with human immunodeficiency virus (HIV)-1 infection, considering also the possible impact of other variables like depression and subjective quality of life.
 
Method / Issue:
DESIGN: Cross-sectional group comparison study, based on neuropsychological performance, of HIV-1 seropositive and HIV-1 seronegative participants. SUBJECTS: Twenty medically asymptomatic HIV-1-seropositive subjects and ten HIV-1-seronegative controls. MEASURES: A battery of neuropsychological tests was administered to assess separately the psychomotor, executive function and memory performance. Mood status was evaluated trough the Beck Depression Inventory (BDI), and subjective quality of life with the SF-36 questionnaire. Given that our research is part of a bigger project including other groups of patients with different pathologies affecting the CNS, we used a non specific HIV measure of QOL in order to compare results in this variable. Cognitive reserve scores were based on a combination of years of education, a measure of occupational attainment, and an estimate of premorbid intelligence.
 
Results / Comments:
The HIV-1-seropositive subjects with low cognitive reserve scores exhibited significantly greater deficits on measures of attention and information processing speed (Stroop, Words-Colour subtest, p=.003), verbal learning and memory (Wechsler Memory Scale, Word list learning curve subtest, p=.029), executive functioning (Wisconsin, Failures to maintain criterium subtest, p=.004), and visuospatial performance (WMS-III , Visual reproduction subtest, p.=.023) than did the HIV-1-seropositive subjects with high cognitive reserve scores. It was not found a relationship between neuropsychological performance and depression (BDI). But, on the other hand, almost all the neuropsychological variables related with Cognitive Reserve were also associated with different scales of quality of life (SF-36).
 
Discussion:
In our sample neuropsychological impairments in HIV-1 infection are most evident in individuals with lower cognitive reserve; that would mean that, as has been found in other neurologic disorders, individuals with greater cognitive reserve may be less sensitive to the initial clinical effects of the underlying neuropathologic process. Although there was a relationship between emotional state and quality of life, the association between neurocognitive performance and quality of life was independent of the severity of emotional distress. It may also suggest a possible influence of cognitive reserve in quality of life insofar as education leads to a better social functioning and acceptance of functional and emotional role.
 
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