Recency effects in HIV-associated dementia are characterized by deficient encoding

The aim of the present study was to investigate the nature and cognitive mechanisms of serial position learning effects in HIV-associated dementia (HAD). Participants were 16 persons with HAD, 50 non-demented persons with HIV-infection, and 50 demographically comparable HIV-seronegative participants. HAD participants, relative to both comparison groups, exhibited reduced middle region (p < 0.01) and elevated recency region (p < 0.05) recall on the Hopkins Verbal Learning Test—Revised, but no primacy region effect (p > 0.10). On recognition testing, the HAD group was impaired in discriminating targets from distractors (p < 0.01) in all three serial position regions; however, they were not impaired on measures of retrieval (p > 0.10) within these same regions. In sum, HAD participants relied disproportionately on recency regions of the list, indicating a passive recall style of echoing only the words within their auditory attention span. Interestingly, HAD participants did not evidence significant improvement on measures of recognition, a finding that suggests that the serial position effects are most consistent with a primary encoding deficit.