 |
|
|
| |
Association between cognitive reserve and cognitive performance in people with HIV: a systematic review and meta-analysis
|
| |
| |
Reported by Jules Levin
9th Intl HIV & Aging Workshop
Sept 13-14 NYC 2018
Kaur N1, Dendukiri N1, Fellows L1, Brouillette M1, Mayo N1
1McGill University , Montreal, Canada
program abstract
Association between cognitive reserve and cognitive performance in people with HIV: a systematic review and meta-analysis
Kaur N1, Dendukiri N1, Fellows L1, Brouillette M1, Mayo N1
1McGill University , Montreal, Canada
Objectives: Cognitive reserve is a potential explanation for the disparity between brain pathology and its clinical manifestations. Individuals with higher cognitive reserve are better shielded against cognitive decline than those with lower reserve. Education, occupation, physical activity and leisure activities are often viewed as contributors to cognitive reserve. Milder forms of HIV-associated neurologic disorders predominate despite revolutionized treatments. Although cognitive reserve has been studied in relation to cognitive ability in HIV, a quantitative synthesis has not been undertaken. This is deemed important as it could encourage development of rehabilitative interventions to offer neuroprotection in HIV. The main objective was to estimate, based on published studies, the strength of the association between cognitive reserve and cognitive performance in individuals with HIV.
Methods: A systematic literature search using Ovid MEDLINE, PsychINFO, and EMBASE was performed to identify studies published between 1990 -2016 that quantified the association between cognitive reserve and cognitive performance in HIV. A random-effects meta-analysis was used to compute a summary estimate (Cohen's d) with 95% confidence intervals (CI) and 95% prediction intervals (PI). The risk of bias and quality of reporting in the studies were indicated by the Appraisal tool for Cross-Sectional Studies (AXIS).
Results: 10 observational studies were deemed eligible. The pooled effect size was 0.9 0.9 (95% CI: 0.7 to 1.0; 95% PI: 0.4 to 1.4). with marked heterogeneity studies [Cochran's Q (df = 9) = 28.0, p =0.0009; I2 statistic=67.4%). Risk-of-bias appraisal showed that non-response bias was never addressed and the items associated with selection bias were only partially met.
Conclusions: The association between cognitive reserve and cognitive performance suggests that building reserve through non-pharmacological interventions could be an effective way of combating cognitive impairment in people with HIV. Encouraging enriched leisure and recreational activities would be one logical recommendation which would not require substantial infrastructure as people could identify these activities in their community.
|
| |
|
|
|
|
|
