Does cognitive intra-individual variability predict change in everyday functioning performance in women with and without HIV in the Women's Interagency HIV Study?

doi:10.1080/23279095.2024.2444573

. 2024 Dec 24:1-11.

doi: 10.1080/23279095.2024.2444573. Online ahead of print.

Does cognitive intra-individual variability predict change in everyday functioning performance in women with and without HIV in the Women's Interagency HIV Study?

David E Vance¹, Yanxun Xu^{2

3}, Raha Dastgheyb⁴, Pauline M Maki⁵, Jiayue Zhang², Gayle Springer⁶, Kathryn Anastos⁷, Deborah R Gustafson⁸, Kathleen M Weber⁹, Derek M Dykxhoorn¹⁰, Joel Milam¹¹, Monica M Diaz¹², Seble G Kassaye¹³, Drenna Waldrop¹⁴, Junghee Lee¹⁵, Mirjam-Colette Kempf¹, Deborah Konkle-Parker¹⁶, Karl Goodkin¹⁷, Andrew J Leviner¹⁸, Matthew Wright¹⁹, Deborah Jones²⁰, Leah H Rubin^{4

6

21}

Affiliations

¹ School of Nursing, University of Alabama at Birmingham, Birmingham, AL, USA.
² Department of Applied Mathematics and Statistics, Johns Hopkins University, Baltimore, MD, USA.
³ Division of Biostatistics and Bioinformatics at The Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
⁴ Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
⁵ Department of Psychiatry and Psychology, University of Illinois at Chicago, Chicago, IL, USA.
⁶ Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, BaltimoreMD, USA.
⁷ Departments of Medicine and Epidemiology & Population Health, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY, USA.
⁸ Department of Neurology, State University of New York Downstate Health Sciences University, Brooklyn, NY, USA.
⁹ Hektoen Institute of Medicine, Chicago, IL, USA.
¹⁰ Dr. John T. Macdonald Foundation Department of Human Genetics, University of Miami, Coral Gables, FL, USA.
¹¹ Department of Epidemiology and Biostatistics, University of California, Irvine, CA, USA.
¹² Department of Neurology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
¹³ Department of Medicine, Division of Infectious Disease and Travel Medicine, Georgetown University, Washington, DC, USA.
¹⁴ Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, USA.
¹⁵ Department of Psychiatry and Behavioral Neurobiology, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA.
¹⁶ School of Nursing/Dept of Medicine/School of Population Health, University of Mississippi Medical Center, Jackson, MS, USA.
¹⁷ Consultant, AIDS Clinical Trials Group/Adapting Clinical Therapeutics Globally (ACTG), Loa Angeles, CA, USA.
¹⁸ Department of Neurology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
¹⁹ Lundquist Institute at Harbor‑UCLA, University of California, Los Angeles, Los Angeles, CA, USA.
²⁰ Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, FL, USA.
²¹ Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA.

PMID: 39718250
PMCID: PMC12185775 (available on 2026-06-24)
DOI: 10.1080/23279095.2024.2444573

Does cognitive intra-individual variability predict change in everyday functioning performance in women with and without HIV in the Women's Interagency HIV Study?

David E Vance et al. Appl Neuropsychol Adult. 2024.

. 2024 Dec 24:1-11.

doi: 10.1080/23279095.2024.2444573. Online ahead of print.

Authors

Affiliations

¹ School of Nursing, University of Alabama at Birmingham, Birmingham, AL, USA.
² Department of Applied Mathematics and Statistics, Johns Hopkins University, Baltimore, MD, USA.
³ Division of Biostatistics and Bioinformatics at The Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
⁴ Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
⁵ Department of Psychiatry and Psychology, University of Illinois at Chicago, Chicago, IL, USA.
⁶ Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, BaltimoreMD, USA.
⁷ Departments of Medicine and Epidemiology & Population Health, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY, USA.
⁸ Department of Neurology, State University of New York Downstate Health Sciences University, Brooklyn, NY, USA.
⁹ Hektoen Institute of Medicine, Chicago, IL, USA.
¹⁰ Dr. John T. Macdonald Foundation Department of Human Genetics, University of Miami, Coral Gables, FL, USA.
¹¹ Department of Epidemiology and Biostatistics, University of California, Irvine, CA, USA.
¹² Department of Neurology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
¹³ Department of Medicine, Division of Infectious Disease and Travel Medicine, Georgetown University, Washington, DC, USA.
¹⁴ Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, USA.
¹⁵ Department of Psychiatry and Behavioral Neurobiology, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA.
¹⁶ School of Nursing/Dept of Medicine/School of Population Health, University of Mississippi Medical Center, Jackson, MS, USA.
¹⁷ Consultant, AIDS Clinical Trials Group/Adapting Clinical Therapeutics Globally (ACTG), Loa Angeles, CA, USA.
¹⁸ Department of Neurology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
¹⁹ Lundquist Institute at Harbor‑UCLA, University of California, Los Angeles, Los Angeles, CA, USA.
²⁰ Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, FL, USA.
²¹ Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA.

PMID: 39718250
PMCID: PMC12185775 (available on 2026-06-24)
DOI: 10.1080/23279095.2024.2444573

Abstract

This study examined the association between cognitive intra-individual variability (IIV), a non-mean-based indicator of underlying neuropathology, and self-reported everyday functioning of 1,086 women with HIV (WWH) and 494 socio-demographically similar women without HIV (WWoH). Objective cognitive performance across seven domains and the self-rated Lawton & Brody scale of Instrumental Activities of Daily Living (IADL) were assessed among participants of the Women's Interagency HIV Study. Two types of cognitive IIV were calculated by taking the standard deviation across seven cognitive domains to calculate dispersion: 1) intra-individual standard deviation (denoted as sdIIV) and 2) coefficient of variation (denoted as covIIV). To account for the longitudinal nature of the data, generalized linear mixed effect models were conducted to examine associations between the dispersion coefficient of cognitive IIV (predictor (sdIIV and covIV)) and functional outcomes (item level scores). Models were conducted in the overall sample (WWH + WWoH), WWH only, virally suppressed (VS)-WWH, and WWoH. sdIIV and covIIV were not associated with any of the IADL items among WWoH but were for WWH and VS-WWH. In WWH covIIV was predictive of poorer functional performance on twice as many IADL items (10 items-money and bills, buying groceries, getting where you need to go, using the phone, home repairs, dressing, laundry, taking/keeping track of medications, taking care of children, work) than sdIIV (5 items). In this study, cognitive IIV predicts functional impairment and different calculations of IIV produce differential predictive value, especially for WWH.

Keywords: Activities of daily living; HIV; cognition; dispersion; instrumental activities of daily living.

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References

1. Adimora AA, Ramirez C, Benning L, Greenblatt RM, Kempf MC, Tien PC, Kassaye SG, Anastos K, Cohen M, Minkoff H, Wingood G, Ofotokun I, Fischl MA, & Gange S (2018, Apr 1). Cohort Profile: The Women’s Interagency HIV Study (WIHS). Int J Epidemiol, 47(2), 393–394i. 10.1093/ije/dyy021 - DOI - PMC - PubMed
1. Anderson AE, Jones JD, Thaler NS, Kuhn TP, Singer EJ, & Hinkin CH (2018, Nov). Intraindividual variability in neuropsychological performance predicts cognitive decline and death in HIV. Neuropsychology, 32(8), 966–972. 10.1037/neu0000482 - DOI - PMC - PubMed
1. Bacon MC, von Wyl V, Alden C, Sharp G, Robison E, Hessol N, Gange S, Barranday Y, Holman S, Weber K, & Young MA (2005, Sep). The Women’s Interagency HIV Study: an observational cohort brings clinical sciences to the bench. Clin Diagn Lab Immunol, 12(9), 1013–1019. 10.1128/CDLI.12.9.1013-1019.2005 - DOI - PMC - PubMed
1. Bangen KJ, Weigand AJ, Thomas KR, Delano-Wood L, Clark LR, Eppig J, Werhane ML, Edmonds EC, & Bondi MW (2019, Jul). Cognitive dispersion is a sensitive marker for early neurodegenerative changes and functional decline in nondemented older adults. Neuropsychology, 33(5), 599–608. 10.1037/neu0000532 - DOI - PMC - PubMed
1. Barkan SE, Melnick SL, Preston-Martin S, Weber K, Kalish LA, Miotti P, Young M, Greenblatt R, Sacks H, & Feldman J (1998, Mar). The Women’s Interagency HIV Study. WIHS Collaborative Study Group. Epidemiology, 9(2), 117–125. https://www.ncbi.nlm.nih.gov/pubmed/9504278 - PubMed

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[1] Adimora AA, Ramirez C, Benning L, Greenblatt RM, Kempf MC, Tien PC, Kassaye SG, Anastos K, Cohen M, Minkoff H, Wingood G, Ofotokun I, Fischl MA, & Gange S (2018, Apr 1). Cohort Profile: The Women’s Interagency HIV Study (WIHS). Int J Epidemiol, 47(2), 393–394i. 10.1093/ije/dyy021 - DOI - PMC - PubMed

[2] Adimora AA, Ramirez C, Benning L, Greenblatt RM, Kempf MC, Tien PC, Kassaye SG, Anastos K, Cohen M, Minkoff H, Wingood G, Ofotokun I, Fischl MA, & Gange S (2018, Apr 1). Cohort Profile: The Women’s Interagency HIV Study (WIHS). Int J Epidemiol, 47(2), 393–394i. 10.1093/ije/dyy021 - DOI - PMC - PubMed

[3] Anderson AE, Jones JD, Thaler NS, Kuhn TP, Singer EJ, & Hinkin CH (2018, Nov). Intraindividual variability in neuropsychological performance predicts cognitive decline and death in HIV. Neuropsychology, 32(8), 966–972. 10.1037/neu0000482 - DOI - PMC - PubMed

[4] Anderson AE, Jones JD, Thaler NS, Kuhn TP, Singer EJ, & Hinkin CH (2018, Nov). Intraindividual variability in neuropsychological performance predicts cognitive decline and death in HIV. Neuropsychology, 32(8), 966–972. 10.1037/neu0000482 - DOI - PMC - PubMed

[5] Bacon MC, von Wyl V, Alden C, Sharp G, Robison E, Hessol N, Gange S, Barranday Y, Holman S, Weber K, & Young MA (2005, Sep). The Women’s Interagency HIV Study: an observational cohort brings clinical sciences to the bench. Clin Diagn Lab Immunol, 12(9), 1013–1019. 10.1128/CDLI.12.9.1013-1019.2005 - DOI - PMC - PubMed

[6] Bacon MC, von Wyl V, Alden C, Sharp G, Robison E, Hessol N, Gange S, Barranday Y, Holman S, Weber K, & Young MA (2005, Sep). The Women’s Interagency HIV Study: an observational cohort brings clinical sciences to the bench. Clin Diagn Lab Immunol, 12(9), 1013–1019. 10.1128/CDLI.12.9.1013-1019.2005 - DOI - PMC - PubMed

[7] Bangen KJ, Weigand AJ, Thomas KR, Delano-Wood L, Clark LR, Eppig J, Werhane ML, Edmonds EC, & Bondi MW (2019, Jul). Cognitive dispersion is a sensitive marker for early neurodegenerative changes and functional decline in nondemented older adults. Neuropsychology, 33(5), 599–608. 10.1037/neu0000532 - DOI - PMC - PubMed

[8] Bangen KJ, Weigand AJ, Thomas KR, Delano-Wood L, Clark LR, Eppig J, Werhane ML, Edmonds EC, & Bondi MW (2019, Jul). Cognitive dispersion is a sensitive marker for early neurodegenerative changes and functional decline in nondemented older adults. Neuropsychology, 33(5), 599–608. 10.1037/neu0000532 - DOI - PMC - PubMed

[9] Barkan SE, Melnick SL, Preston-Martin S, Weber K, Kalish LA, Miotti P, Young M, Greenblatt R, Sacks H, & Feldman J (1998, Mar). The Women’s Interagency HIV Study. WIHS Collaborative Study Group. Epidemiology, 9(2), 117–125. https://www.ncbi.nlm.nih.gov/pubmed/9504278 - PubMed

[10] Barkan SE, Melnick SL, Preston-Martin S, Weber K, Kalish LA, Miotti P, Young M, Greenblatt R, Sacks H, & Feldman J (1998, Mar). The Women’s Interagency HIV Study. WIHS Collaborative Study Group. Epidemiology, 9(2), 117–125. https://www.ncbi.nlm.nih.gov/pubmed/9504278 - PubMed

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Does cognitive intra-individual variability predict change in everyday functioning performance in women with and without HIV in the Women's Interagency HIV Study?

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Does cognitive intra-individual variability predict change in everyday functioning performance in women with and without HIV in the Women's Interagency HIV Study?

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