Prospective Memory in HIV-1 Infection

HIV-1 感染中的前瞻性记忆

• 批准号: 8243702
• 负责人: Steven Paul Woods
• 金额: $ 51.7万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN DIEGO
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-03-04 至 2013-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8243702
• 关键词: AIDS Dementia Complex; Activities of Daily Living; Adult; Adverse effects; Affect; Aging; Anti-Retroviral Agents; Area; Biological Markers; Caring; Centers for Disease Control and Prevention (U.S.); Characteristics; Clinical; Clinical Research; Cognitive; Cognitive Therapy; Data; Dementia; Dependence; Development; Diagnosis; Disease; Disease Outcome; Disease Progression; Early Diagnosis; Early identification; Education; Elderly; Epidemic; Episodic memory; Etiology; Event; Funding; Future; Grant; HIV; HIV Infections; HIV-1; Health; Household; Impaired cognition; Impairment; Incidence; Independent Living; Infection; Intention; Life; Literature; Longitudinal Studies; Measures; Memory; Memory impairment; Modeling; Morbidity - disease rate; Nature; Neuraxis; Neurobiology; Neurocognitive; Neuronal Injury; Neuropathogenesis; Neuropsychology; Occupational; Occupational activity of managing finances; Outcome; Parkinson Disease; Patient Self-Report; Performance; Persons; Pharmaceutical Preparations; Play; Population; Prevalence; Process; Provider; Public Health; Publishing; Quality of life; Relative (related person); Research; Research Design; Research Project Grants; Research Support; Retrieval; Risk; Risk Factors; Risk Marker; Role; Screening procedure; Substance Addiction; Time; age effect; antiretroviral therapy; base; clinical practice; cognitive function; cognitive system; daily functioning; executive function; follow-up; functional decline; functional disability; functional outcomes; health related quality of life; improved; infancy; innovation; instrumental activity of daily living; interest; medical appointment; medication compliance; mortality; neuropsychiatry; neuropsychological; novel; programs; prospective; prospective memory; public health relevance; relating to nervous system; remediation; social; tau Proteins; therapy design; volunteer

DESCRIPTION (provided by applicant): Prospective memory (ProM), which refers to the successful execution of a future intention (i.e., "remembering to remember"), plays a vital role in everyday functioning (e.g., remembering to attend medical appointments), maintaining optimal health (e.g., remembering to take medications), and enabling independent living (e.g., remembering to pay the household bills). The uniqueness of this construct is supported by research showing that ProM is separable from retrospective memory (and global cognitive functioning) at the neuropsychological, functional, and neurobiological levels. The scientific merits of examining ProM in HIV infection are fourfold: 1) it enhances our understanding of the cognitive systems affected by the disease; 2) it impacts public health by improving the early identification of neuropsychological and functional impairments, which remain prevalent in the era of combination antiretroviral therapies; 3) it advances standard clinical neuropsychological practice; and 4) it informs targeted treatments. The current R01 has yielded the first published evidence that HIV is associated with elevated ProM complaints and impaired ProM performance, which are functionally and neurobiologically distinct from HIV-associated deficits in retrospective memory. Importantly, HIV-associated ProM impairment is a unique and robust predictor of declines in daily functioning, demonstrating incremental ecological validity relative to traditional measures of retrospective memory, executive functions, and global cognitive impairment. A novel direction for this revised competing renewal, as supported by pilot data from the initial funding period, will be to examine the additive effects of aging on HIV-associated ProM impairment. The incidence and prevalence of HIV infection in older adults are rising and consequently of considerable public health importance. The study of ProM is highly relevant to older HIV-infected adults, who may be at greater risk for exacerbated HIV-associated CNS complications (e.g., dementia), which increases the likelihood of dependence in daily functioning (e.g., medication nonadherence). Although ProM is impaired in healthy older adults and persons with HIV infection, no studies to date have evaluated the combined effects of these risk factors on ProM. Accordingly, this competing renewal aims to extend the findings from the initial grant period by: 1) focusing on older adults with HIV, who are a growing but understudied population in the changing HIV epidemic; 2) expanding the study design to examine the incidence of ProM impairment and its risk factors; 3) broadening our conceptual model to include habitual ProM; and 4) examining an important new functional outcome, health-related quality of life. To accomplish these aims, we propose a 5-year, longitudinal study to evaluate 125 older HIV+, 75 older HIV-, 125 younger HIV+, and 75 younger HIV- volunteers on comprehensive neuropsychological, functional, psychiatric, and neuromedical assessments. This new direction of research aims to bolster the clinical value of HIV-associated ProM impairment as an early marker of functional declines (e.g., medication nonadherence) and poorer health outcomes in older HIV-infected adults, as well as to directly inform the development of targeted pharmacological and cognitive-behavioral therapies. PUBLIC HEALTH RELEVANCE This study will evaluate the combined effects of aging and HIV infection on prospective memory, which is a unique cognitive ability that describes one's ability to "remember to remember" and plays a vital role in performing normal daily functions, especially adhering to medications. As such, this project will identify the day- to-day impact of prospective memory impairment in older adults with HIV infection, including its relationship to medication adherence and quality of life. Findings from this study will help in the early detection of HIV- associated prospective memory impairment, as well as in the development of treatments designed to limit the everyday effects of such deficits on older adults with HIV infection and their care providers.

描述（由申请人提供）：前瞻性记忆（PROM），指的是成功执行未来意图（即“记住记住记住”），在日常功能中起着至关重要的作用（例如，记得记住参加医疗预约），保持最佳健康状况，保持最佳健康状况（例如，记住要服用药物），并付出独立的生活（例如，付费（例如，记住）付费（例如，付费）。这种结构的独特性得到了研究的支持，表明舞会与神经心理学，功能和神经生物学水平上的回顾性记忆（和全球认知功能）可分开。检查艾滋病毒感染中舞会的科学优点是四重：1）它增强了我们对受疾病影响的认知系统的理解； 2）它通过改善神经心理学和功能障碍的早期鉴定来影响公共卫生，这些障碍在抗逆转录病毒疗法的时代仍然普遍存在； 3）它提高了标准的临床神经心理学实践； 4）它为有针对性的治疗提供了信息。当前的R01产生了第一个发表的证据，表明HIV与舞会投诉升高和舞会表现受损相关，在功能和神经生物学上与回顾性记忆中与HIV相关的缺陷不同。重要的是，与艾滋病毒相关的舞会障碍是日常功能下降的独特且可靠的预测指标，相对于回顾性记忆，执行功能和全球认知障碍的传统措施，表明了生态有效性的增量。在初始资金期间的试点数据支持的支持下，这种经过修订的竞争续约的新方向将是检查衰老对与HIV相关的PROM损害的添加作用。老年人艾滋病毒感染的发病率和患病率正在上升，因此公共卫生的重要性很大。对PROM的研究高度与感染的HIV感染的成年人高度相关，他们可能面临加重HIV相关的CNS并发症（例如痴呆症）的风险，从而增加了日常功能依赖的可能性（例如，药物不贴心）。尽管在健康的老年人和HIV感染的人中会损害PROM，但迄今为止，尚无研究评估这些危险因素对PROM的综合作用。因此，这种竞争性更新的目的是通过以下方式将发现从最初的赠款期延长：1）专注于艾滋病毒的老年人，他们在不断变化的艾滋病毒流行病中越来越多但人口研究了； 2）扩大研究设计以检查舞会障碍及其危险因素的发生率； 3）扩大我们的概念模型以包括习惯舞会； 4）检查重要的新功能结果，与健康相关的生活质量。为了实现这些目标，我们提出了一项五年的纵向研究，以评估125个年龄较大的HIV+，75个年龄较大的HIV-，125名年轻的HIV+和75名年轻的HIV-艾滋病毒志愿者，涉及全面的神经心理学，功能，精神病学和神经医学评估。这一新的研究方向旨在增强与HIV相关的Prom障碍的临床价值，作为功能下降的早期标志（例如，药物不遵守性）和较老的HIV感染的成年人的健康结果，并直接为靶向的药理和认知性行为 - 行为 - 行为 - 行为 - 行为 - 行为 - 疾病的发展。 公共卫生相关性本研究将评估衰老和艾滋病毒感染对预期记忆的综合影响，这是一种独特的认知能力，描述了一个人“记住记住”的能力，并在执行正常的日常功能，尤其是遵守药物方面起着至关重要的作用。因此，该项目将确定预期记忆力障碍的日常影响，包括艾滋病毒感染的老年人，包括其与药物依从性和生活质量的关系。这项研究的结果将有助于早期发现HIV相关的前瞻性记忆障碍，以及开发旨在限制此类缺陷对HIV感染及其护理提供者的老年人日常影响的治疗方法。