Impact of HIV on Cognitive Performance in Professional Drivers.
Impact of HIV on Cognitive Performance in Professional Drivers.
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DOI：
10.1097/qai.0000000000002899
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发表时间：
2022-04-15
影响因子：
3.6
通讯作者：
Thomas, Kevin G. F.
中科院分区：
文献类型：
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作者：
Gouse, Hetta;Masson, Catherine J.;Henry, Michelle;Dreyer, Anna;Robbins, Reuben N.;Kew, Greg;Joska, John A.;London, Leslie;Marcotte, Thomas D.;Thomas, Kevin G. F.
关键词：
对智力要求很高的现代工作场所往往依赖于良好的认知健康，然而，对于在驾车等高风险职业工作的受雇人员中，与艾滋病毒相关的神经认知功能障碍是如何表现出来的，人们几乎不了解。艾滋病毒相关的神经认知障碍也与较差的长期认知、健康和就业结果有关。这项设在南非开普敦的研究评估了艾滋病毒对受雇男性职业司机神经心理测试成绩的影响。我们进行了一组跨越七个认知领域的神经心理测试，并从三组职业司机(68名艾滋病毒携带者，55名有心血管风险的男性和81名对照组)获得了行为数据、人体测量和医学生物标志物。我们比较了司机的认知特征，并使用多元回归模型来调查在考虑了潜在的混淆的社会人口和临床变量(即收入、家庭语言、抑郁和Framingham风险评分)后，组间差异是否持续存在。与其他研究参与者相比，携带艾滋病毒的职业司机在评估处理速度(p<；.003)和注意力和工作记忆(p=.018)的测试中表现明显较差。在控制了潜在的混杂因素后，群体成员资格仍然是认知表现的预测指标。然而，在艾滋病毒携带者中观察到的认知缺陷主要表现为轻微或无症状。与这一特征一致的是，他们在神经心理测试中相对较差的表现并不能概括为自我报告的日常生活能力障碍。携带艾滋病毒的司机可能面临长期健康和就业结果较差的风险。需要监测和支持他们长期认知健康的计划。
The intellectually demanding modern workplace is often dependent on good cognitive health, yet there is little understanding of how neurocognitive dysfunction related to HIV presents in employed individuals working in high risk vocations like driving. HIV-associated neurocognitive impairment is also associated with poorer long term cognitive, health and employment outcomes. This study, set in Cape Town, South Africa, assessed the effects of HIV on neuropsychological test performance in employed male professional drivers. We administered a neuropsychological test battery spanning seven cognitive domains and obtained behavioral data, anthropometry, and medical biomarkers from three groups of professional drivers (68 men with HIV, 55 men with cardiovascular risk, and 81 controls). We compared the drivers’ cognitive profiles, and used multiple regression modelling to investigate whether between-group differences persisted after considering potentially confounding sociodemographic and clinical variables (i.e., income, home language, depression, and Framingham Risk Score). Relative to other study participants, professional drivers with HIV performed significantly more poorly on tests assessing processing speed (p<.003) and attention and working memory (p=.018). Group membership remained a predictor of cognitive performance after controlling for potential confounders. The cognitive deficits observed in men with HIV were, however, largely characterized as being mild or asymptomatic. Consistent with this characterization, their relatively poor performance on neuropsychological testing did not generalize to self-reported impairment on activities of daily living. Drivers with HIV may be at risk for poorer long-term health and employment outcomes. Programs that monitor and support their long-term cognitive health are needed.