Correlates of Metamemory in Middle-Aged and Older Adults With and Without HIV in the Deep South: A Cross-Sectional Study

Older people living with HIV (PLWH) are at risk for metacognitive deficits or decreased awareness of one's cognitive abilities. This cross-sectional secondary analysis assessed metacognition and its clinicodemographic correlates among adults. Among 174 PLWH and 105 people living without HIV, we used the Multifactorial Memory Questionnaire (MMQ) and a subjective and objective memory concordance variable yielding accurate/normal, accurate/impaired, underestimators (subjective impairment but no objective impairment), and overestimators (objective impairment but no subjective impairment). Bivariate tests and logistic regressions were conducted. PLWH self-reported worse memory. Using memory strategies was associated with White race, better education, and better cognitive function, whereas depressive symptoms and poorer subjective memory were associated. Race and depression explained memory discordance among PLWH. Executive function explained additional variance in memory concordance. PLWH demonstrate deficits in metacognition. Increasing memory strategy use (particularly among underserved groups) and targeting depression and executive function may be ideal interventions.