Attention in HIV

2015 ii 2015 KATHLEEN M. VAN DYK Some rights reserved. This work is licensed under a Creative Commons Attribution 4.0 United States License. iii This manuscript has been read and accepted for the Graduate Faculty in Psychology in satisfaction of the dissertation requirement for the degree of Doctor of Philosophy. iv Abstract ATTENTION IN HIV In contrast to the striking benefit of advances in antiretroviral therapy on longevity and health in the HIV+ population, mild cognitive disorders persist (Heaton, Clifford et al., 2010). Additional factors that may be related to cognitive decline and warrant consideration in this population are aging and physical health status. Among cognitive domains affected, attention and processing speed have emerged as particularly vulnerable to the effects of HIV. There are also age effects observed in these domains, and we proposed that reduced physical health can also impact cognition in these areas, comparably to pain. Sensitive measures of attention that vary attentional demands may be sensitive to subtle cognitive changes associated with aging and physical health status in this population. We examined the impact of aging and self-reported physical health status on several attentional measures that vary attentional demands in a sample of HIV+ adults. We hypothesized that worse physical health and older age would uniquely and additively relate to poorer performances during test conditions of greatest demands. Results indicated that both low physical health and older age each affected performance on attention tasks, with unique main effects observed on different tasks. There were additive effects observed on several attention tasks during high load conditions, with differences largely observed at the extremes; i.e., older adults in poor health demonstrated worse performance compared to younger adults in good health. Importantly, one task indicated worst performance in younger adults in poor health. The results of these findings are discussed in terms of clinical implications and the importance of considering these factors when assessing for cognitive decline in the HIV+ population.