Hostname: page-component-6bb9c88b65-s7dlb Total loading time: 0 Render date: 2025-07-24T18:21:21.024Z Has data issue: false hasContentIssue false
  • English
  • Français

Self-reported everyday functioning among adults with human immunodeficiency virus: Longitudinal associations with global neurocognitive functioning and depressive symptoms

Published online by Cambridge University Press:  07 July 2025

Maximo R. Prescott Open the ORCID record for Maximo R. Prescott [Opens in a new window] ,
Emily W. Paolillo ,
Carlos D. Rivera Saldana Open the ORCID record for Carlos D. Rivera Saldana [Opens in a new window] ,
Donald Franklin ,
Elizabeth C. Pasipanodya ,
Mariam A. Hussain Open the ORCID record for Mariam A. Hussain [Opens in a new window] ,
Raeanne C. Moore Open the ORCID record for Raeanne C. Moore [Opens in a new window] ,
Robert K. Heaton ,
Jessica L. Montoya  and
David J. Moore
...Show all authors
Maximo R. Prescott*
Affiliation:
Department of Psychiatry, UC San Diego, San Diego, CA, USA San Diego State University/UC San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA
Emily W. Paolillo
Affiliation:
Department of Neurology, Memory and Aging Center, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA
Carlos D. Rivera Saldana
Affiliation:
Department of Psychiatry, UC San Diego, San Diego, CA, USA
Donald Franklin
Affiliation:
Department of Psychiatry, UC San Diego, San Diego, CA, USA
Elizabeth C. Pasipanodya
Affiliation:
Rehabilitation Research Center, Santa Clara Valley Medical Center, Santa Clara, CA, USA
Mariam A. Hussain
Affiliation:
Department of Psychiatry, UC San Diego, San Diego, CA, USA Mental illness Research, Education and Clinical Center, Veterans Affairs San Diego Healthcare System, San Diego, CA, USA
Raeanne C. Moore
Affiliation:
Department of Psychiatry, UC San Diego, San Diego, CA, USA
Robert K. Heaton
Affiliation:
Department of Psychiatry, UC San Diego, San Diego, CA, USA
Jessica L. Montoya
Affiliation:
Department of Psychiatry, UC San Diego, San Diego, CA, USA
David J. Moore
Affiliation:
Department of Psychiatry, UC San Diego, San Diego, CA, USA
*
Corresponding author: Maximo R. Prescott; Email: mrprescott@health.ucsd.edu
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

Diagnosing HIV-Associated Neurocognitive Disorders (HAND) requires attributing neurocognitive impairment and functional decline at least partly to HIV-related brain effects. Depressive symptom severity, whether attributable to HIV or not, may influence self-reported functioning. We examined longitudinal relationships among objective global cognition, depressive symptom severity, and self-reported everyday functioning in people with HIV (PWH).

Methods:

Longitudinal data from 894 PWH were collected at a university-based research center (2002–2016). Participants completed self-report measures of everyday functioning to assess both dependence in instrumental activities of daily living (IADL) and subjective cognitive difficulties at each visit, along with depressive symptom severity (BDI-II). Multilevel modeling examined within- and between-person predictors of self-reported everyday functioning outcomes.

Results:

Participants averaged 6 visits over 5 years. Multilevel regression showed a significant interaction between visit-specific global cognitive performance and mean depression symptom severity on likelihood of dependence in IADL (p = 0.04), such that within-person association between worse cognition and greater likelihood of IADL dependence was strongest among individuals with lower mean depressive symptom severity. In contrast, participants with higher mean depressive symptom severity had higher likelihoods of IADL dependence regardless of cognition. Multilevel modelling of subjective cognitive difficulties showed no significant interaction between global cognition and mean depressive symptom severity (p > 0.05).

Conclusions:

The findings indicate a link between cognitive abilities and IADL dependence in PWH with low to moderate depressive symptoms. However, those with higher depressive symptoms severity report IADL dependence regardless of cognitive status. This is clinically significant because everyday functioning is measured through self-report rather than performance-based assessments.

Keywords

NeurocognitiveimmunodeficiencydepressionHANDmultileveldependence

Information

Type
Research Article
Information
Journal of the International Neuropsychological Society , First View , pp. 1 - 8
Copyright
© The Author(s), 2025. Published by Cambridge University Press on behalf of International Neuropsychological Society

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Article purchase

Temporarily unavailable

References

American Psychiatric Association. (2000). Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR). American Psychiatric Association.Google Scholar
Antinori, A., Arendt, G., Becker, J. T., Brew, B. J., Byrd, D. A., Cherner, M., Clifford, D. B., Cinque, P., Epstein, L. G., Goodkin, K., Gisslen, M., Grant, I., Heaton, R. K., Joseph, J., Marder, K., Marra, C. M., McArthur, J. C., Nunn, M., Price, R. W., …Wojna, V. E. (2007). Updated research nosology for HIV-associated neurocognitive disorders. Neurology, 69(18), 1789–1799.10.1212/01.WNL.0000287431.88658.8bCrossRefGoogle Scholar
Atkinson, J. H. Jr., Grant, I., Kennedy, C. J., Richman, D. D., Spector, S. A., & McCutchan, J. A. (1988). Prevalence of psychiatric disorders among men infected with human immunodeficiency virus. A controlled study. Archives of General Psychiatry, 45(9), 859–864.10.1001/archpsyc.1988.01800330091011CrossRefGoogle Scholar
Bates, D., Mächler, M., Bolker, B., & Walker, S. (2015). Fitting linear mixed-effects models using lme4. Journal of Statistical Software, 67(1), 1–48.10.18637/jss.v067.i01CrossRefGoogle Scholar
Beck, A. T., Steer, R. A., & Brown, G. K. (1996). Beck Depression Inventory-II, vol. 78. The Psychological Corporation.Google Scholar
Becker, S., Solbrig, S., Michaelis, K., Faust, B., Brockmann, K., & Liepelt-Scarfone, I. (2022). Divergence between informant and self-ratings of activities of daily living impairments in Parkinson’s disease. Frontiers in Aging Neuroscience, 14, 838674. https://doi.org/10.3389/fnagi.2022.838674 CrossRefGoogle Scholar
Blackstone, K., Moore, D. J., Heaton, R. K., Franklin, D. R. Jr., Woods, S. P., Clifford, D. B., Collier, A. C., Marra, C. M., Gelman, B. B., McArthur, J. C., Morgello, S., Simpson, D. M., Rivera-Mindt, M., Deutsch, R., Ellis, R. J., Hampton Atkinson, J., Grant, I. (2012). Diagnosing symptomatic HIV-associated neurocognitive disorders: Self-report versus performance-based assessment of everyday functioning. Journal of the International Neuropsychological Society, 18(1), 79–88.10.1017/S135561771100141XCrossRefGoogle Scholar
Burmester, B., Leathem, J., & Merrick, P. (2016). Subjective cognitive complaints and objective cognitive function in aging: A systematic review and meta-analysis of recent cross-sectional findings. Neuropsychology Review, 26(4), 376–393.10.1007/s11065-016-9332-2CrossRefGoogle Scholar
Carter, S. L., Rourke, S. B., Murji, S., Shore, D., & Rourke, B. P. (2003). Cognitive complaints, depression, medical symptoms, and their association with neuropsychological functioning in HIV infection: A structural equation model analysis. Neuropsychology, 17(3), 410–419.10.1037/0894-4105.17.3.410CrossRefGoogle Scholar
Chelune, G. J., Heaton, R. K., & Lehman, R. A. W. (1986). Neuropsychological and personality correlates of patients’ complaints of disability. In Advances in Clinical Neuropsychology (pp. 95–126). Springer.10.1007/978-1-4613-2211-5_4CrossRefGoogle Scholar
Clare, L., Whitaker, R., Quinn, C., Jelley, H., Hoare, Z., Woods, B., & Wilson, B. (2012). AwareCare: Development and validation of an observational measure of awareness in people with severe dementia. Neuropsychological Rehabilitation, 22(1), 113–133.10.1080/09602011.2011.640467CrossRefGoogle Scholar
Clifford, D. B., & Ances, B. M. (2013). HIV-associated neurocognitive disorder. Lancet Infectious Diseases, 13(11), 976–986.10.1016/S1473-3099(13)70269-XCrossRefGoogle Scholar
Cody, S. L., & Vance, D. E. (2016). The neurobiology of HIV and its impact on cognitive reserve: A review of cognitive interventions for an aging population. Neurobiology of Disease, 92(Pt B), 144–156.10.1016/j.nbd.2016.01.011CrossRefGoogle Scholar
Cysique, L. A., Franklin, D., Abramson, I., Ellis, R. J., Letendre, S., Collier, A., Clifford, D., Gelman, B., McArthur, J., Morgello, S., Simpson, D., McCutchan, J. A., Grant, I., Heaton, R. K., the CHARTER group & the HNRC group (2011). Normative data and validation of a regression based summary score for assessing meaningful neuropsychological change. Journal of Clinical and Experimental Neuropsychology, 33(5), 505–522.10.1080/13803395.2010.535504CrossRefGoogle Scholar
Gonda, X., Pompili, M., Serafini, G., Carvalho, A. F., Rihmer, Z., & Dome, P. (2015). The role of cognitive dysfunction in the symptoms and remission from depression. Annals of General Psychiatry, 14(1), 27.10.1186/s12991-015-0068-9CrossRefGoogle Scholar
Heaton, R. K., Clifford, D. B., Franklin, D. R., Woods, S. P., Ake, C., Vaida, F., Ellis, R. J., Letendre, S. L., Marcotte, T. D., Atkinson, J. H., Rivera-Mindt, M., Vigil, O. R., Taylor, M. J., Collier, A. C., Marra, C. M., Gelman, B. B., McArthur, J. C., Morgello, S., Simpson, D. M., …CHARTER Group (2010). HIV-associated neurocognitive disorders persist in the era of potent antiretroviral therapy: CHARTER study. Neurology, 75(23), 2087–2096.10.1212/WNL.0b013e318200d727CrossRefGoogle Scholar
Heaton, R. K., Marcotte, T. D., Mindt, M. R., Sadek, J., Moore, D. J., Bentley, H., & HNRC Group (2004). The impact of HIV-associated neuropsychological impairment on everyday functioning. Journal of the International Neuropsychological Society, 10(3), 317–331.10.1017/S1355617704102130CrossRefGoogle Scholar
Heaton, R. K., Marcotte, T. D., Mindt, M. R., Sadek, J., Moore, D. J., Bentley, H., Grant, I., & HNRC Group (2004). The impact of HIV-associated neuropsychological impairment on everyday functioning. Journal of the International Neuropsychological Society, 10(3), 317–331.10.1017/S1355617704102130CrossRefGoogle Scholar
Hülür, G., Hertzog, C., Pearman, A., Ram, N., & Gerstorf, D. (2014). Longitudinal associations of subjective memory with memory performance and depressive symptoms: Between-person and within-person perspectives. Psychology and Aging, 29(4), 814–827.10.1037/a0037619CrossRefGoogle Scholar
Jacob, A. E., Fazeli, P. L., Crowe, M. G., & Vance, D. E. (2022). Correlates of subjective and objective everyday functioning in middle-aged and older adults with human immunodeficiency virus. Applied Neuropsychology: Adult, 31(5), 1–13.Google Scholar
Kamat, R., Morgan, E., Marcotte, T. D., Badiee, J., Maich, I., Cherner, M., Almeida, S., de Pereira, A. P., Ribeiro, C. E., Barbosa, F., Atkinson, J. H., & Ellis, R. (2013). Implications of apathy and depression for everyday functioning in HIV/AIDS in Brazil. Journal of Affective Disorders, 150(3), 1069–1075.10.1016/j.jad.2012.11.040CrossRefGoogle Scholar
Koenig, A. M., Bhalla, R. K., & Butters, M. A. (2014). Cognitive functioning and late-life depression. Journal of the International Neuropsychological Society, 20(5), 461–467.10.1017/S1355617714000198CrossRefGoogle Scholar
Kordovski, V. M., Tierney, S. M., & Woods, S. P. (2021). Conceptualizing and assessing everyday functioning in the context of HIV-associated neurocognitive disorders. Current Topics in Behavioral Neurosciences, 50, 329–346.10.1007/7854_2018_78CrossRefGoogle Scholar
Laverick, R., Haddow, L., Daskalopoulou, M., Lampe, F., Gilson, R., Speakman, A., & Rodger, A. (2017). Self-reported decline in everyday function, cognitive symptoms, and cognitive function in people with HIV. JAIDS Journal of Acquired Immune Deficiency Syndromes, 76(3), e74–e83.10.1097/QAI.0000000000001468CrossRefGoogle Scholar
Mausbach, B. T., Depp, C. A., Bowie, C. R., Harvey, P. D., McGrath, J. A., Thronquist, M. H., & Patterson, T. L. (2011). Sensitivity and specificity of the UCSD Performance-based Skills Assessment (UPSA-B) for identifying functional milestones in schizophrenia. Schizophrenia Research, 132(2-3), 165–170.10.1016/j.schres.2011.07.022CrossRefGoogle Scholar
McArdle, J. J., & Nesselroade, J. R. (2003). Growth curve analysis in contemporary psychological research. In Handbook of psychology: Research methods in psychology. vol. 2, pp. 447–480). John Wiley & Sons, Inc.10.1002/0471264385.wei0218CrossRefGoogle Scholar
Moore, D. J., Palmer, B. W., Patterson, T. L., & Jeste, D. V. (2007). A review of performance-based measures of functional living skills. Journal of Psychiatric Research, 41(1-2), 97–118.10.1016/j.jpsychires.2005.10.008CrossRefGoogle Scholar
Neigh, G. N. (2016). Neurobiology of HIV-associated neuropsychiatric and neurocognitive disorders. Neurobiology of Disease, 92(Pt B), 113–115.10.1016/j.nbd.2016.05.006CrossRefGoogle Scholar
Norman, M. A., Moore, D. J., Taylor, M., Franklin, D., Cysique, L., Ake, C., Lazarretto, D., Vaida, F., Heaton, R. K., & HNRC Group (2011). Demographically corrected norms for African Americans and Caucasians on the hopkins verbal learning test-revised, brief visuospatial memory test-revised, stroop color and word test, and wisconsin card sorting test 64-card version. Journal of Clinical and Experimental Neuropsychology, 33(7), 793–804. https://doi.org/10.1080/13803395.2011.559157 CrossRefGoogle Scholar
Nweke, M., Mshunqane, N., Govender, N., Akinpelu, A. O., & Ukwuoma, M. (2022). Impact of HIV-associated cognitive impairment on functional independence, frailty and quality of life in the modern era: A meta-analysis. Scientific Reports, 12(1), 6470.10.1038/s41598-022-10474-8CrossRefGoogle Scholar
Obermeit, L. C., Beltran, J., Casaletto, K. B., Franklin, D. R., Letendre, S., Ellis, R., Fennema-Notestine, C., Vaida, F., Collier, A. C., Marra, C. M., Clifford, D., Gelman, B., Sacktor, N., Morgello, S., Simpson, D., McCutchan, J. A., Grant, I., Heaton, R. K., & CNS HIV Anti-Retroviral Therapy Effects Research (CHARTER) Group. (2017). Evaluating the accuracy of self-report for the diagnosis of HIV-associated neurocognitive disorder (HAND): defining “symptomatic” versus “asymptomatic” HAND. Journal of NeuroVirology, 23(1), 67–78.10.1007/s13365-016-0474-zCrossRefGoogle Scholar
Paolillo, E. W., Pasipanodya, E. C., Moore, R. C., Pence, B. W., Atkinson, J. H., Grelotti, D. J., & Moore, D. J. (2020). Cumulative burden of depression and neurocognitive decline among persons with HIV: A longitudinal study. Journal of Acquired Immune Deficiency Syndromes, 84(3), 304–312.10.1097/QAI.0000000000002346CrossRefGoogle Scholar
Paul Woods, S., Morgan, E. E., Dawson, M., Cobb Scott, J., Grant, I., & The HIV Neurobehavioral Research Center (HNRC) Group (2006). Action (verb) fluency predicts dependence in instrumental activities of daily living in persons infected with HIV-1. Journal of Clinical and Experimental Neuropsychology, 28(6), 1030–1042.10.1080/13803390500350985CrossRefGoogle Scholar
Srisurapanont, M., Suttajit, S., Eurviriyanukul, K., & Varnado, P. (2017). Discrepancy between objective and subjective cognition in adults with major depressive disorder. Scientific Reports, 7(1), 3901.10.1038/s41598-017-04353-wCrossRefGoogle Scholar
Thames, A. D., Becker, B. W., Marcotte, T. D., Hines, L. J., Foley, J. M., Ramezani, A., Singer, E. J., Castellon, S. A., Heaton, R. K., & Hinkin, C. H. (2011). Depression, cognition, and self-appraisal of functional abilities in HIV: An examination of subjective appraisal versus objective performance. Clinical Neuropsychologist, 25(2), 224–243.10.1080/13854046.2010.539577CrossRefGoogle Scholar
Woods, S. P., Moore, D. J., Weber, E., & Grant, I. (2009). Cognitive neuropsychology of HIV-associated neurocognitive disorders. Neuropsychology Review, 19(2), 152–168.10.1007/s11065-009-9102-5CrossRefGoogle Scholar
World Health Organization. (1998). Composite International Diagnostic Interview (CIDI, version 2.1). World Health Organization.Google Scholar