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Objectives: In the neuroHIV literature, cognitive reserve has most often been operationalized using education, occupation, and IQ. The effects of other cognitively stimulating activities that might be more amenable to interventions have been little studied. The purpose of this study was to develop an index of cognitive reserve in people with HIV, combining multiple indicators of cognitively stimulating lifetime experiences into a single value. Methods: The data set was obtained from a Canadian longitudinal study (N = 856). Potential indicators of cognitive reserve captured at the study entry included education, occupation, engagement in six cognitively stimulating activities, number of languages spoken, and social resources. Cognitive performance was measured using a computerized test battery. A cognitive reserve index was formulated using logistic regression weights. For the evidence on concurrent and predictive validity of the index, the measures of cognition and self-reported everyday functioning were each regressed on the index scores at study entry and at the last follow-up [mean duration: 25.9 months (SD 7.2)], respectively. Corresponding regression coefficients and 95% confidence intervals (CIs) were computed. Results: Professional sports [odds ratio (OR): 2.9; 95% CI 0.59–14.7], visual and performance arts (any level of engagement), professional/amateur music, complex video gaming and competitive games, and travel outside North America were associated with higher cognitive functioning. The effects of cognitive reserve on the outcomes at the last follow-up visit were closely similar to those at study entry. Conclusion: This work contributes evidence toward the relative benefit of engaging in specific cognitively stimulating life experiences in HIV. [ABSTRACT FROM AUTHOR]

Cognitive reserve is a potential explanation for the disparity between brain pathology and its clinical manifestations. The main objective of this study was to estimate, based on published studies, the strength of the association between cognitive reserve and cognitive performance in individuals with HIV. A systematic literature search using Ovid MEDLINE, PsychINFO, and EMBASE was performed to identify studies published between 1990 and 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). Ten observational studies were deemed eligible. The pooled effect size was 0.9 (95% CI: 0.7–1.0; 95% PI: 0.4–1.4) with marked heterogeneity studies [Cochran's Q (df = 9) = 28.0, p =.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. The association between cognitive reserve and cognitive performance suggests that building reserve through non-pharmacological interventions could be a potentially effective way of combating cognitive impairment in people with HIV. [ABSTRACT FROM AUTHOR]

Background: It is now recognized that individuals with mild cognitive impairment (MCI) face subtle functional declines that can compromise performance in everyday tasks. However, it is still not clear how to capture these declines in the clinical setting. Thus, the goal of this study was to conduct a scoping review to identify performance-based tools for which the psychometric properties have been evaluated with the MCI population. Methods: A scoping review of the scientific literature was performed with the guidance of a health science librarian in searching the MEDLINE, PsychINFO, CINAHL, and EMBASE databases from their inception until May 2014. Results: Nine performance-based tools assessing functional performance in individuals with MCI have been identified in the literature. While construct and content validity have been extensively reported, only two tools provided data on reliability. Conclusion: Considering that functional decline is part of the normal aging process, it might be challenging to differentiate normal from pathological functional decline in this population. Functional measurement tools might be very sensitive to capture these subtle changes. Although no recommendations can be proposed at this point on a specific tool to assess functional performance in MCI, research in this area is beginning to identify the elements that should be taken into consideration when choosing a tool. [ABSTRACT FROM AUTHOR]