The Role of Neurocognitive Intra-Individual Variability in Predicting Neurocognitive Change over Time in HIV+ Adults

The primary aim of the current study was to investigate the role neurocognitive dispersion, a form of neurocognitive intra-individual variability , in predicting change in neurocognitive functioning over time. Our particular focus was to shed light through a relatively novel approach at measuring neurocognitive functioning, neurocognitive intra-individual variability, that has shown promise in predicting neurocognitive and functional declines, and has largely been overlooked in the context of HIV. A large racially/ethnically diverse sample of HIV+ adults were followed longitudinally and underwent extensive neuropsychological and neuromedical evaluations at each study visit. After applying recently published, regression-based norms to characterize neurocognitive change over time in the sample, we found that almost 40% of participants demonstrated neurocognitive change over 3 years on average, with 50% of participants remaining stable, 33% declining, 7% improving, and most surprisingly, around 14% with demonstrating a variable trajectory (i.e., oscillating between declines and improvements). Study results indicated that reduced neurocognitive dispersion was associated with greater neurocognitive improvement. Younger age, non-Hispanic White (compared to Latino/a), and past opiate/sedative use disorder were associated with greater risk of neurocognitive decline. The results of the current study provide additional information to the growing literature of the variable disease progression of HIV, particularly on its impact on the central nervous system. Additionally, this study adds to the field of neuroAIDS disparities by providing additional baseline demographic, psychiatric, and neurocognitive predictors of neurocognitive change. Overall, the present study provides additional evidence of the complex trajectory associated with neurocognitive change in the context of HIV as well as the various demographic, and clinical factors that can impact it