Impairments in Component Processes of Executive Function and Episodic Memory in Alcoholism, HIV Infection, and HIV Infection with Alcoholism Comorbidity. (19th October 2016)

• Record Type: Journal Article
• Authors: Fama, Rosemary; Sullivan, Edith V.; Sassoon, Stephanie A.; Pfefferbaum, Adolf; Zahr, Natalie M.
• Is Part Of: Alcoholism. Volume 40:Number 12(2016)
• Page Start: 2656
• Page End: 2666
• Publication Date: 2016-10-19
• Subjects: HIV Infection -- Alcoholism -- Executive Functions -- Episodic Memory -- Comorbidity; Alcoholism -- Periodicals; Alcoholism -- Periodicals; Alcoolisme; Electronic journals; Périodique électronique (Descripteur de forme); Ressource Internet (Descripteur de forme); 616.861005
• DOI: 10.1111/acer.13250
• Languages: English
• ISSNs: 0145-6008

Abstract

Abstract : Background: Executive functioning and episodic memory impairment occur in HIV infection (HIV) and chronic alcoholism (ALC). Comorbidity of these conditions (HIV + ALC) is prevalent and heightens risk of vulnerability to separate and compounded deficits. Age and disease‐related variables can also serve as mediators of cognitive impairment and should be considered, given the extended longevity of HIV‐infected individuals in this era of improved pharmacological therapy. Methods: HIV, ALC, HIV + ALC, and normal controls (NC) were administered traditional and computerized tests of executive function and episodic memory. Test scores were expressed as age‐ and education‐corrected Z ‐scores; selective tests were averaged to compute Executive Function and Episodic Memory Composite scores. Efficiency scores were calculated for tests with accuracy and response times. Results: HIV, ALC, and HIV + ALC had lower scores than NC on Executive Function and Episodic Memory Composites, with HIV + ALC even lower than ALC and HIV on the Episodic Memory Composite. Impairments in planning and free recall of visuospatial material were observed in ALC, whereas impairments in psychomotor speed, sequencing, narrative free recall, and pattern recognition were observed in HIV. Lower decision‐making efficiency scores than NC occurred in all 3 clinical groups. In ALC, age and lifetime alcohol consumption were each unique predictors of Executive Function and Episodic Memory Composite scores. In HIV + ALC, age was a unique predictor of Episodic Memory Composite score. Conclusions: Disease‐specific and disease‐overlapping patterns of impairment in HIV, ALC, and HIV + ALC have implications regarding brain systems disrupted by each disease and clinical ramifications regarding the complexities and compounded damping of cognitive functioning associated with dual diagnosis that may be exacerbated with aging. Abstract : Neuropsychological impairments occur in alcoholism (ALC) and HIV infection (HIV). Their comorbidity (HIV+ALC) is prevalent and heightens risk of dysfunction. Focus on executive functions and episodic memory processes revealed impairments in planning and visuospatial free recall in ALC, whereas psychomotor speed, sequencing, verbal free recall, and pattern recognition were impaired in HIV. Decision‐making (accuracy and efficiency), impulsivity, and set shifting were compromised in all three groups; HIV+ALC impairment involved all functions and processes examined with a compounded deficit in spatial recognition.