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Speed of Processing Training Can Improve Cognitive Function for People with HIV

Completing 10 hours of exercises designed to enhance mental processing speed led to improvements in cognitive functioning for middle-aged and older people with HIV and increased their ability to carry out daily tasks, researchers reported in the November 2012 Journal of the Association of Nurses in AIDS Care. 

Even in the era of effective combination antiretroviral therapy, neurocognitive impairment remains common among HIV positive people. Its causes are not fully understood, but HIV infection itself, associated inflammation and metabolic changes, and side effects of antiretroviral drugs may all play a role. One aspect of impaired function is slower mental processing, which can interfere with activities of daily living.

David Vance from the University of Alabama at Birmingham School of Nursing and colleagues conducted a pilot study to evaluate whether speedof processing training could improve cognitive functioning in older adults with HIV.

The analysis included 46 middle-age and older adults with HIV. Half the participants were randomly assigned to complete 10 hours of computerized speed of processing training (developed by Posit Science) while the remainder received no training.

"These studies have shown that even as people age, computer-based cognitive training improves speed of processing, sustained visual attention, and complex reaction time," Vance noted in a university press release. "The goal was to see if the same held true for people with HIV-based cognitive issues."

Before and after training, the researchers compared results from a set of neurocognitive assessments that measured how quickly people can perform mental skills such as assimilating information, understanding relationships, and developing reasonable conclusions. They also looked at results from the standardized Timed Instrumental Activities of Daily Living (TIADL) Test.

Results

• Participants who completed the training showed significant improvement on the Useful Field of View Test and TIADL Test compared to those who did not receive training.
• More than 90% of participants reported that they felt that the training at least moderately improved their cognitive functioning.

Based on these findings, the researchers concluded, "This study demonstrated that speed of processing training may improve cognitive and everyday functioning in this growing population."

"The group that did the computer-based training showed significant improvements in visual processing speed and attention -- an important measure of brain function -- as well as in timed instrumental activities of daily living, which measure how quickly a person can do everyday activities, versus the group that did not use the computer-based training," Vance elaborated.

Today, more than 25% of people living with HIV in the U.S. are older than 50 and 30% to 60% of adults living with HIV experience cognitive problems at some point during their illness, according to the press release.

"It’s imperative for people with HIV and their treatment teams be proactive in addressing cognitive problems as they emerge, because without treatment these issues -- which mimic premature aging -- can lead to difficulties in working and living independently," Vance added. "This study shows people with HIV have non-pharmacologic options to consider that can improve cognitive functioning in areas that directly affect quality of life."

10/23/12

Reference

DE Vance, PL Fazeli, LA Ross, et al. Speedof Processing Training With Middle-Age and Older Adults With HIV: A Pilot Study. Journal of the Association of Nurses in AIDS Care 23(6):500-510. November 2012.

Other Source

J Lollar, University of Alabama at Birmingham. Cognitive Training Helps Adults with HIV, UAB Study Finds. UAB News press release. October 16, 2012.