Cognitive Reserve Influences Neuropsychological and Everyday Functions Among Individuals Infected with Hepatitis C

Objective: Higher levels of cognitive reserve (CR) may be protective against the neuropsychological manifestation of neuropathology across a variety of clinical disorders. However, the role of CR in the expression of neurocognitive deficits among persons infected with the hepatitis C virus (HCV) is not well understood. Method: Thirty-nine HCV-infected participants were classified as having either high (n = 19) or low (n = 20) CR based on education attainment, word reading, and IQ scores. A sample of 40 demographically comparable healthy adults (HA) was also included. All participants completed the Neuropsychological Assessment Battery (NAB), Delis-Kaplan Executive Function System (D-KEFS), and Behavioral Rating Inventory of Executive Function (BRIEF). Results: Linear regression analyses, controlling for gender, depression, and lifetime substance use disorders, found significant effects of the study group (HCV High CR, HCV Low CR, and HA) on fluency, attention, executive function, memory, and everyday function T-scores (ps < .05, adjusted R2 range = .09-.18), but not in learning or the BRIEF (ps > .10). Pairwise comparisons revealed that the HCV Low CR group performed significantly below the other cohorts (ps < .05), who did not differ from one another (ps > .10). Conclusion: Although HCV infection may increase the risk of neurocognitive impairment, HCV-infected persons with high CR performed similarly to HA in the majority of cognitive domains and everyday functions. Higher levels of CR may, therefore, be protective of the neurobehavioral manifestation of neural injury associated with HCV infection. Future studies on the longitudinal protective value of CR on incident HCV-associated neurocognitive declines and everyday functioning outcomes (e.g., employment) may be warranted.