title: A neuropsychological investigation of multitasking in HIV infection: implications for everyday functioning.
abstract: OBJECTIVE
  A subset of individuals with HIV-associated neurocognitive impairment experience related deficits in "real world" functioning (i.e., independently performing instrumental activities of daily living [IADL]). While performance-based tests of everyday functioning are reasonably sensitive to HIV-associated IADL declines, questions remain regarding the extent to which these tests' highly structured nature fully captures the inherent complexities of daily life. The aim of this study was to assess the predictive and ecological validity of a novel multitasking measure in HIV infection.
  
  
  METHODS
  Participants included 60 individuals with HIV infection (HIV+) and 25 demographically comparable seronegative adults (HIV-). Participants were administered a comprehensive neuropsychological battery, questionnaires assessing mood and everyday functioning, and a novel standardized test of multitasking, which involved balancing the demands of four interconnected performance-based functional tasks (i.e., financial management, cooking, medication management, and telephone communication).
  
  
  RESULTS
  HIV+ individuals demonstrated significantly worse overall performance, fewer simultaneous task attempts, and increased errors on the multitasking test as compared to the HIV- group. Within the HIV+ sample, multitasking impairments were modestly associated with deficits on standard neuropsychological measures of executive functions, episodic memory, attention/working memory, and information processing speed, providing preliminary evidence for convergent validity. More importantly, multivariate prediction models revealed that multitasking deficits were uniquely predictive of IADL dependence beyond the effects of depression and global neurocognitive impairment, with excellent sensitivity (86%), but modest specificity (57%).
  
  
  CONCLUSIONS
  Taken together, these data indicate that multitasking ability may play an important role in successful everyday functioning in HIV+ individuals.
authors.affiliation: San Diego State University and University of California, San Diego, CA, USA. cobb.scott@yale.edu
authors.forename: J Cobb
authors.initials: JC
authors.lastname: Scott
authors.forename: Steven Paul
authors.initials: SP
authors.lastname: Woods
authors.forename: Ofilio
authors.initials: O
authors.lastname: Vigil
authors.forename: Robert K
authors.initials: RK
authors.lastname: Heaton
authors.forename: Brian C
authors.initials: BC
authors.lastname: Schweinsburg
authors.forename: Ronald J
authors.initials: RJ
authors.lastname: Ellis
authors.forename: Igor
authors.initials: I
authors.lastname: Grant
authors.forename: Thomas D
authors.initials: TD
authors.lastname: Marcotte
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D003072:Cognition Disorders / Q000175:diagnosis* / Q000209:etiology*; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D013223:Statistics as Topic