title: Effects of information processing speed on learning, memory, and executive functioning in people living with HIV/AIDS.
abstract: BACKGROUND
  It is unclear whether or to what degree literacy, aging, and other neurologic abnormalities relate to cognitive deficits among people living with HIV/AIDS in the combined antiretroviral therapy (CART) era. The primary aim of this study was to simultaneously examine the association of age, HIV-associated motor abnormalities, major depressive disorder, and reading level with information processing speed, learning, memory, and executive functions, and to determine whether processing speed mediated any of the relationships between cognitive and noncognitive variables.
  
  
  METHODS
  Participants were 186 racially and ethnically diverse men and women living with HIV/AIDS who underwent comprehensive neurological, neuropsychological, and medical evaluations. Structural equation modeling was utilized to assess the extent to which information processing speed mediated the relationship between age, motor abnormalities, major depressive disorder, and reading level with other cognitive abilities.
  
  
  RESULTS
  Age, motor dysfunction, reading level, and current major depressive disorder were all significantly associated with information processing speed. Information processing speed fully mediated the effects of age on learning, memory, and executive functioning and partially mediated the effect of major depressive disorder on learning and memory. The effect of motor dysfunction on learning and memory was fully mediated by processing speed.
  
  
  CONCLUSIONS
  These findings provide support for information processing speed as a primary deficit, which may account, at least in part, for many of the other cognitive abnormalities recognized in complex HIV/AIDS populations. The association of age and information processing speed may account for HIV/aging synergies in the generation of CART-era cognitive abnormalities.
authors.affiliation: a Department of Neurology , The Icahn School of Medicine at Mount Sinai , New York , NY , USA.
authors.forename: Robert P
authors.initials: RP
authors.lastname: Fellows
authors.forename: Desiree A
authors.initials: DA
authors.lastname: Byrd
authors.forename: Susan
authors.initials: S
authors.lastname: Morgello
mesh_terms: D000328:Adult; D000367:Age Factors; D003072:Cognition Disorders / Q000209:etiology* / Q000821:virology; D015331:Cohort Studies; D056344:Executive Function / Q000502:physiology*; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000523:psychology*; D006801:Humans; D007859:Learning Disabilities / Q000209:etiology* / Q000821:virology; D008297:Male; D008569:Memory Disorders / Q000209:etiology* / Q000821:virology; D008875:Middle Aged; D015233:Models, Statistical; D019964:Mood Disorders / Q000209:etiology; D009069:Movement Disorders / Q000209:etiology; D009460:Neurologic Examination; D009483:Neuropsychological Tests; D011569:Psychiatric Status Rating Scales
keywords: Executive function; Human immunodeficiency virus; Information processing speed; Memory; Structural equation model
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