Prospective memory and spontaneous compensatory mnemonic strategy use in the laboratory and daily life in HIV-associated neurocognitive disorders

Introduction Older adults with HIV-associated neurocognitive disorders (HAND) are at high risk for deficits in the resource-demanding, strategic aspects of prospective memory (PM) that can adversely affect health outcomes. This study examined the frequency and correlates of spontaneous compensatory strategy use during a laboratory-based PM task and its associations with the use of mnemonic strategies in daily life. Method Participants included 53 older adults with HAND, 89 older persons with HIV without HAND, and 62 seronegatives who completed the Cambridge Prospective Memory Test (CAMPROMPT), on which the type, frequency, and quality of their compensatory strategy use was quantified. Participants also completed self-report measures of PM symptoms and the frequency of mnemonic compensatory strategy use in daily life. Result There were no significant group-level effects on strategy use during the CAMPROMPT. Persons with HAND had moderately lower time-, but not event-based PM scores. Higher compensatory strategy use was strongly associated with better PM, particularly for time-based cues. Moreover, higher compensatory strategy use on the CAMPROMPT was associated with more frequent general mnemonic strategy use in daily life, and specifically with more frequent use of internal PM strategies (e.g., visualization) for medication adherence. Conclusion Spontaneous compensatory mnemonic strategy use can support PM performance among older adults with HAND in the laboratory. Strategy use in the laboratory may be a marker for the extent to which older adults with HAND use other compensatory strategies to support memory in their daily life. Future studies may examine whether compensatory mnemonic strategies can be taught and used to support PM in the daily lives of older persons with HIV disease.