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Randomized Controlled Trial
. 2024 Feb;38(2):471-492.
doi: 10.1080/13854046.2023.2212867. Epub 2023 May 16.

A 2-year longitudinal randomized controlled trial examining the transfer of speed of processing training to secondary cognitive domains in middle-aged and older adults with HIV-associated neurocognitive disorder: Results of the think fast study

David E Vance  1 , Pariya L Fazeli  1 , Andres Azuero  1 , Jennifer S Frank  1 , Virginia G Wadley  2 , James L Raper  3 , Caitlin N Pope  4 , Karlene K Ball  5
Affiliations
Randomized Controlled Trial

A 2-year longitudinal randomized controlled trial examining the transfer of speed of processing training to secondary cognitive domains in middle-aged and older adults with HIV-associated neurocognitive disorder: Results of the think fast study

David E Vance et al. Clin Neuropsychol. 2024 Feb.

Abstract

Objective: As people with HIV (PWH) age, they are at-risk of developing cognitive impairments compared to their seronegative counterparts. Although speed of processing (SOP) training may help improve this cognitive ability, less work has examined transfer to other cognitive domains. This study examined the effect of SOP training has on secondary cognitive domains in PWH aged 40+ years.

Method: In this 3-group 2-year longitudinal study, 216 PWH with HIV-associated neurocognitive disorder (HAND) or borderline HAND were randomized to either: (1) 10 h of SOP training (n = 70); (2) 20 h of SOP training (n = 73); or (3) 10 h of an active control training (n = 73). Participants completed a comprehensive cognitive battery at baseline, immediately after training, and at 1 and 2 years. This battery yielded global and domain specific T-scores as well as a cognitive impairment variable. Generalized linear mixed-effect models were fitted to estimate between-group mean differences at the follow-up time-points adjusted for baseline.

Results: No clinically or statistically significant improvements in any of the cognitive outcomes were observed. A sensitivity analysis was conducted; conclusions replicated those of the main analysis, with two exceptions: Global Function T and Psychomotor Speed T showed relevant training improvements among the intervention groups over the control group at the immediate post time point.

Conclusions: Although SOP training has been shown to improve cognitive abilities that correspond to driving and mobility, such training has limited therapeutic utility in improving cognition in other domains in PWH with HAND.

Trial registration: ClinicalTrials.gov NCT02758093.

Keywords: Brain fitness; HIV-Associated neurocognitive disorder; cognitive reserve; cognitive training; neuroplasticity; speed of processing.

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Conflict of interest statement

Conflicts of Interest/Competing Interests

Non-financial Interests – David E. Vance, Pariya L. Fazeli, Andres Azuero, Jennifer S. Frank, Virginia G. Wadley, James L. Raper, and Caitlin N. Pope report no real or perceived vested interest that related to this article that could be construed as a conflict of interest.

Financial Interests – Karlene Ball has a commercial interest in the UFOV test used in this study.

Figures

Figure 1.
Figure 1.
Consort Diagram of Think Fast Study. Notes: COVID=Corona Virus Disease; HAND=HIV-Associated Neurocognitive Disorder.
See this image and copyright information in PMC

References

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