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Operationalization of the updated diagnostic algorithm for classifying HIV-related cognitive impairment and dementia

Published online by Cambridge University Press:  19 November 2010

J. M. Foley ,
M. J. Wright ,
A. L. Gooding ,
M. Ettenhofer ,
M. Kim ,
M. Choi ,
S. A. Castellon ,
J. Sadek ,
R. K. Heaton  and
W. G. van Gorp
...Show all authors
J. M. Foley*
Affiliation:
UCLA Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry and Biobehavioral Sciences, Los Angeles, California, U.S.A.
M. J. Wright
Affiliation:
UCLA Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry and Biobehavioral Sciences, Los Angeles, California, U.S.A.
A. L. Gooding
Affiliation:
VA Greater Los Angeles Healthcare System, Los Angeles, California, U.S.A.
M. Ettenhofer
Affiliation:
UCLA Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry and Biobehavioral Sciences, Los Angeles, California, U.S.A.
M. Kim
Affiliation:
VA Greater Los Angeles Healthcare System, Los Angeles, California, U.S.A.
M. Choi
Affiliation:
UCSD Department of Psychiatry, San Diego, California, U.S.A.
S. A. Castellon
Affiliation:
UCLA Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry and Biobehavioral Sciences, Los Angeles, California, U.S.A. VA Greater Los Angeles Healthcare System, Los Angeles, California, U.S.A.
J. Sadek
Affiliation:
University of New Mexico Department of Psychiatry, Albuquerque, New Mexico, U.S.A.
R. K. Heaton
Affiliation:
UCSD Department of Psychiatry, San Diego, California, U.S.A.
W. G. van Gorp
Affiliation:
Columbia University Medical Center Department of Psychiatry, New York, U.S.A.
T. D. Marcotte
Affiliation:
UCSD Department of Psychiatry, San Diego, California, U.S.A.
C. H. Hinkin
Affiliation:
UCLA Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry and Biobehavioral Sciences, Los Angeles, California, U.S.A. VA Greater Los Angeles Healthcare System, Los Angeles, California, U.S.A.
*
Correspondence should be addressed to: Jessica Foley, PhD, 150 S, Huntington Avenue, Boston, MA 02130, U.S.A. Phone: +1 954-600-1518; Fax: +1 310-591-8024. Email: Jfoley@post.harvard.edu.
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Abstract

Background: This study applies the updated HIV-Associated Neurocognitive Disorders (HAND) diagnostic algorithm.

Methods: Participants were 210 HIV-infected-adults, classified using proposed HAND criteria: HIV-Associated Dementia (HAD), Mild Neurocognitive Disorder (MND), Asymptomatic Neurocognitive Impairment (ANI).

Results: The algorithm yielded: normal = 32.8%, ANI = 21.4%, MND = 34.3%, and HAD = 11.4%. Normal participants performed superior to HAND-defined participants on cognition, and HAD participants performed more poorly on global cognition and executive functioning. Two distinct subgroups of interest emerged: (1) functional decline without cognitive impairment; (2) severe cognitive impairment and minimal functional compromise.

Conclusions: The algorithm discriminates between HIV-infected cognitively impaired individuals. Diagnosis yields two unique profiles requiring further investigation. Findings largely support the algorithm's utility for diagnosing HIV-cognitive-impairment, but suggest distinct subsets of individuals with discrepant cognitive/functional performances that may not be readily apparent by conventional application of HAND diagnosis.

Keywords

HIVcognitive impairmentclassificationdementia
Type
Research Article
Information
International Psychogeriatrics , Volume 23 , Issue 5 , June 2011 , pp. 835 - 843
Copyright
Copyright © International Psychogeriatric Association 2010

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References

Albert, S. et al. (1999). An observed performance test of medication management ability in HIV: relation to neuropsychological status and medication adherence outcomes. AIDS and Behaviors, 3, 121–128.Google Scholar
American Academy of Neurology (1996). Clinical confirmation of the American Academy of Neurology algorithm for HIV-1-associated cognitive/motor disorder. Neurology, 47, 1247–1253.Google Scholar
Antinori, A. et al. (2007). Updated research nosology for HIV-associated neurocognitive disorders (HAND). Neurology, 69, 1789–1799.Google Scholar
Beck, A. and Steer, R. (1993). Beck Anxiety Inventory Manual. San Antonio, TX: The Psychological Corporation.Google Scholar
Beck, A., Steer, G. and Brown, G. (1996). Beck Depression Inventory, Second Edition Manual. San Antonio, TX: The Psychological Corporation.Google Scholar
Benedict, R. (1997). Brief Visuospatial Memory Test-Revised. Odessa, FL: Psychological Assessment Resources.Google Scholar
Benton, A. L. and Hamsher, K. (1983). Multilingual Aphasia Examination. Iowa City, Iowa: AJA Associates.Google Scholar
Bloom, F. E. and Rausch, D. M. (1997). HIV in the brain: pathology and neurobehavioral consequences. Journal of NeuroVirology, 3, 102–109.CrossRefGoogle ScholarPubMed
Bottiggi, K.A., et al. (2007). The HIV dementia scale: predictive power in mild dementia and HAART. Journal of the Neurological Sciences, 260, 11–15.Google Scholar
Brandt, J. (1991). The Hopkins Verbal Learning Test: development of a new verbal memory test with six equivalent forms. Clinical Neuropsychologist, 5, 125–142.Google Scholar
Broadbent, D. E., Copper, P. F., Fitzgerald, P. and Parkes, K. R. (1982). The Cognitive Failures Questionnaire (CFQ) and its correlates. British Journal of Clinical Psychology, 21, 1–16.Google Scholar
Cherner, M. et al. (2007). Neuropathologic confirmation of definitional criteria for human immunodeficiency virus-associated neurocognitive disorders. Journal of NeuroVirology, 13, 23–28.CrossRefGoogle ScholarPubMed
Delis, D. C., Kramer, J. H., Kaplan, E. and Ober, B. A. (1987). California Verbal Learning Test: Adult Version. San Antonio, TX: The Psychological Corporation.Google Scholar
First, M. B., Spitzer, R. L., Gibbon, M. and Williams, J. B. (1995). Structured Clinical Interview for DSM-IV, Axis I Disorders (Patient Edition). New York: Biometrics Research Department, New York State Psychiatric Institute.Google Scholar
Grant, I., Heaton, R. K. and Atkinson, J. H. (1995). Neurocognitive disorders in HIV-1 infection. Current Topics in Microbiology and Immunology, 202, 11–32.Google Scholar
Gronwall, D. M. A. (1977). Paced Auditory Serial Addition Task: a measure of recovery from concussion. Perceptual and Motor Skills, 44, 367–373.CrossRefGoogle ScholarPubMed
Halstead, W. C. (1947). Brain and Intelligence. Chicago: University of Chicago Press.Google Scholar
Heaton, R. and Staff, P. (2000). WCST-64: Computer Version Scoring Program for Windows (WCST-64: SP) Research Edition. Odessa, FL: Psychological Assessment Resources.Google Scholar
Heaton, R. K. et al. (2004). The impact of HIV-associated neuropsychological impairment on everyday functioning. Journal of the International Neuropsychological Society, 10, 317–331.Google Scholar
Hinkin, C. H., van Gorp, W. G., Satz, P., Weisman, J. D., Thommes, J. and Buckingham, S. (1992). Depressed mood and its relationship to neuropsychological test performance in HIV-1 seropositive individuals. Journal of Clinical and Experimental Neuropsychology, 14, 289–297.Google Scholar
Janssen, R. S. et al. (1991). Nomenclature and research case definitions for neurological manifestations of human immunodeficiency virus type-1 (HIV-1) infection. Report of a Working Group of the American Academy of Neurology AIDS Task Force. Neurology, 41, 778–785.Google Scholar
Lawton, M. P. and Brody, E. M. (1969). Assessment of older people: self maintaining and instrumental activities of daily living. Gerontologist, 9, 179–186.CrossRefGoogle ScholarPubMed
Matthews, C. G. and Klove, H. (1964). Instruction Manual for the Adult Neuropsychology Test Battery. Madison, WI: University of Wisconsin Medical School.Google Scholar
Reitan, R. M. and Wolfson, D. (1993). The Halstead-Reitan Neuropsychological Test Battery: Theory and clinical interpretation. Tuscon, AZ: Neuropsychology Press.Google Scholar
Rosenthal, T. J., Parseghian, Z., Allen, R. W. and Stein, A. C. (1995). STISIM: The Low Cost Driving Simulator. Hawthorne, CA: Systems Technology, Inc.Google Scholar
Smith, A. (1991). Symbol Digit Modalities Test. Los Angeles, CA: Western Psychological Services.Google Scholar
Stroop, J. R. (1935). Studies of interference in serial verbal reactions. Journal of Experimental Psychology, 18, 643–662.Google Scholar
Wechsler, D. (1997). Manual for the Wechsler Adult Intelligence Scale – Third Edition. San Antonio, TX: The Psychological Corporation.Google Scholar
Wilkinson, G. S. (1993). The Wide Range Achievement Test. Wilmington, DE: Wide Range, Inc.Google Scholar