Diagnostic accuracy of new and old cognitive screening tools for <scp>HIV</scp>‐associated neurocognitive disorders

Trunfio, Mattia; Vai, Daniela; Montrucchio, Chiara; Alcantarini, Chiara; Livelli, A; Tettoni, MC; Orofino, Giancarlo; Audagnotto, Sabrina; Imperiale, Daniele; Bonora, Stefano; Perri, Giovanni Di; Calcagno, Andrea

doi:10.1111/hiv.12622

Cited by 21 publications

(16 citation statements)

References 37 publications

(93 reference statements)

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“…Even though we did not see domain-specific differences here, our findings overall suggest that different measures can produce different conclusions, and that the sensitivity, validity, and cultural relevance of cognitive measures are of critical importance when examining the relationship between HIV and cognitive function. Future studies using the OCS-Plus and other novel cognitive function assessment tools designed to be more appropriate in low-literacy settings are recommended 40 . Such novel tools when validated in population-based studies could then be adopted for use in clinical settings to assess cognitive function.…”

Section: Discussionmentioning

confidence: 99%

Cognitive differences associated with HIV serostatus and antiretroviral therapy use in a population-based sample of older adults in South Africa

Asiimwe

Farrell

Kobayashi

et al. 2020

Sci Rep

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Previous clinical studies have reported adverse cognitive outcomes for people living with HIV (PLWH), but there are no population-based studies comparing cognitive function between older PLWH and comparators without HIV in sub-Saharan Africa. We analyzed baseline data of 40 + years-old participants in “Health and Aging in Africa: A Longitudinal Study of an INDEPTH Community in South Africa” (HAALSI) cohort. We measured cognition using a battery of conventional instruments assessing orientation, immediate- and delayed-recall, and numeracy (N = 4560), and the Oxford Cognitive Screen [OCS]-Plus, a novel instrument for low-literacy populations, assessing memory, language, visual-spatial ability, and executive functioning (N = 1997). Linear regression models comparing cognitive scores between participants with and without HIV were adjusted for sex, education, age, country of birth, father’s occupation, ever-consumed alcohol, and asset index. PLWH scored on average 0.06 (95% CI 0.01–0.12) standard deviation (SD) units higher on the conventional cognitive function measure and 0.02 (95% CI − 0.07 to 0.04) SD units lower on the OCS-Plus measure than HIV-negative participants. We found higher cognitive function scores for PLWH compared to people without HIV when using a conventional measure of cognitive function but not when using a novel instrument for low-literacy settings.

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Section: Discussionmentioning

confidence: 99%

Cognitive differences associated with HIV serostatus and antiretroviral therapy use in a population-based sample of older adults in South Africa

Asiimwe

Farrell

Kobayashi

et al. 2020

Sci Rep

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“…In contrast, clock drawing tests showed a poor screening performance for HAND in one study; however, medication adherence was not addressed, and the population was younger than our population. 26 Given these results, the CLOX 1 may merit further study in HIV populations 65 years of age or older as a measure that can help identify persons who may not adhere to prescribed ART. The finding that the GPB may be associated with HIV medication adherence is supported by previous research in neuropsychological evaluation in HIV.…”

Section: Discussionmentioning

confidence: 99%

“…Clock drawing tests, TMT, and GPB have been used to assess cognition (eg, executive function) in heterogeneous populations, including persons with HIV. 23-26 The CLOX 1 asks the patient to “Draw me a clock that says 1:45. Set the hands and numbers on the face so that a child could read them.” The CLOX 2 is similar; however, the investigator draws the clock first and then asks the participant to copy it.…”

Section: Methodsmentioning

confidence: 99%

Association Between Cognitive Tests and Antiretroviral Medication Adherence in Older Adults With HIV

et al. 2018

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CLOX 1 and GPB were significantly related to adherence ( P < 0.05). Comparison of the magnitude of each measure's relation to adherence suggests that the GPB is a better indicator of ability to adhere ( R = 0.514 vs R = 0.381). Conclusion and Relevance: CLOX 1 and GPB demonstrated an association with adherence in patients 65 years of age or older with HIV. Although the use of these tests to measure adherence in older persons with HIV seems promising, more research is needed to ascertain their ultimate utility.

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“…Questo test, che analizza prevalentemente l'orientamento visuospaziale, è considerato uno dei migliori strumenti di screening per il decadimento neurocognitivo in pazienti HIV-negativi (23). Il nostro gruppo ha recentemente presentato i dati dell'utilizzo del CDT come test di screening: in 279 soggetti HIV-positivi il CDT alterato ha avuto una sensibilità del 30.1%, una specificità del 71.6% e un correct classification rate del 52.2% (28). Infine è importante valutare la prevalenza di patologie ossee come osteopenia ed osteoporosi, la cui prevalenza è aumentata soprattutto a causa di effetti indesiderati di alcuni farmaci antiretrovirali.…”

Section: Figuraunclassified

La geriatria nell’infezione da HIV

Biagini¹,

Montrucchio²,

Calcagno³

et al. 2017

JHA

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RiassuntoIn seguito all'introduzione di terapie antiretrovirali sempre più efficaci, i pazienti HIV-positivi raggiungono un'aspettativa di vita di poco inferiore ai soggetti HIV-negativi; il fenomeno dell'invecchiamento porta con sé nuovi problemi nella di gestione di questi pazienti, soprattutto riguardo la presenza di comorbidità età-correlate non secondarie all'infezione da HIV e all'utilizzo cronico di farmaci, oltre a quelli antiretrovirali. Per delineare più precisamente questo fenomeno emergente, in questo studio sono stati analizzati 107 pazienti sieropositivi, con età maggiore di 65 anni, e sono state prese in considerazione comorbidità presenti, politerapia assunta e tre principali aree di interesse: il rischio cardiovascolare, la presenza di deficit neurocognitivi e il rischio di patologie ossee. I risultati provenienti da questo studio mostrano una percentuale significativa di pazienti con rischio cardiovascolare elevato (variabile da 68,5% a 88,5% in base allo score di rischio utilizzato). Inoltre, il 55,9% dei pazienti valutati ha mostrato uno spessore intima media carotideo anormale, indice di danno endoteliale. I pazienti sono stati sottoposti a batterie di test psicologici di screening: deficit neurocognitivi potenziali sono stati osservati in percentuali variabili tra il 15,7% (FAB) e il 65,3% (IHDS) e necessitano di ulteriori test approfonditi. Anche riguardo al rischio di patologie ossee (valutato con ultrasonografia al calcagno) sono emersi valori di T score compatibili con osteopenia e osteoporosi rispettivamente nel 40,8% e 2% dei pazienti valutati. In conclusione, l'alta prevalenza di patologie età-correlata emersa in questo studio mostra l'esigenza di un nuovo tipo di gestione del paziente sieropositivo over-65, finalizzata alla prevenzione e alla gestione multidisciplinare. Abstract Following the introduction of more effective antiretroviral therapies, life expectancy in HIV-positive patients is nowadays slightly lower than in HIV-

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Diagnostic accuracy of new and old cognitive screening tools for HIV‐associated neurocognitive disorders

Cited by 21 publications

References 37 publications

Cognitive differences associated with HIV serostatus and antiretroviral therapy use in a population-based sample of older adults in South Africa

Cognitive differences associated with HIV serostatus and antiretroviral therapy use in a population-based sample of older adults in South Africa

Association Between Cognitive Tests and Antiretroviral Medication Adherence in Older Adults With HIV

La geriatria nell’infezione da HIV

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