HIV-related neurocognitive impairment screening: the patient's perspective on its utility and psychological impact

Abstract

Despite ever improving advances in antiretroviral therapy, neurocognitive impairments such as asymptomatic and mild neurocognitive impairment remain a significant problem for the HIV-positive population. We distributed a post-neurocognitive impairment screening service evaluation questionnaire to assess satisfaction and anxiety. Subjects were HIV positive and aged 18-50. They were screened using the Brief Neurocognitive Score and International HIV Dementia Score as well as undergoing screening for anxiety (Generalised Anxiety Disorder Assessment [GAD-7]), depression (Participant Health Questionnaire Mood Scale [PHQ-9]) and memory (Everyday Memory Questionnaire [EMQ-R]). On completion, they were either reassured that the tests were normal or were referred for further investigation. Following assessment, subjects were asked to complete an anonymous satisfaction survey; 101 surveys were analysed. Forty-nine per cent of participants stated that they "felt better" following screening, 43% said it "made no difference", 6% stated it "worried me" and 1% "did not understand". On a scale of 0-10 of helpfulness, the mean score was 7.53. Forty-seven subjects indicated that they were referred for further investigation and 46 subjects that nothing else was needed; 8 reported they did not know. Those referred on rated satisfaction at a mean of 7.54/10 and those with normal screen as 7.09/10 (p = 0.46). Of the groups that were referred for further investigation, 6% said the test "worried them" compared to 4% in the non-referred group. Forty-nine per cent said they "felt better" despite an abnormal result compared to 50% in a normal screening result (p = 0.76). The results of this survey show that screening for neurocognitive impairment by this method is acceptable and helpful to participants. It did not lead to an increase in anxiety and there was no correlation between referred for further investigations and anxiety suggesting concerns about creating undue anxiety by screening and referral are unfounded.

Evaluation of the Everyday Memory Questionnaire-Revised in a menopausal population: understanding the brain fog during menopause

“…The Everyday Memory Questionnaire-Revised (EMQ-R) is a subjective measure of memory failure in everyday life, which was initially developed as a 35-item questionnaire to investigate the effects of closed-head injuries on memory performance 22 . Subsequently, this questionnaire was reduced by Royle and Lincoln 23 to a 13-item one (EMQ-R) and validated in several clinical populations, such as stroke, 24 chronic pain, 25 and human immunodeficiency virus, 26 and nonclinical populations, such as a community of younger and older adults 27 and Bosnian/Serbian healthy adults 28 . Although the item loadings were slightly different in these studies, two main factors of the EMQ-R were consistently observed with one factor relating to memory retrieval and another focusing on the attentional process, suggesting that the EMQ-R may serve as a better option to measure brain fog because of this bifactor structure ( Retrieval and Attentional ).…”

Neurocognitive Impairment in Patients with HIV and Depression in Nigeria

“…Another possible explanation for high NCI prevalence despite a reasonable viral suppression rate may be a history of severe immunosuppression before the commencement of treatment, a risk factor for NCI. An important biomarker of severe immunosuppression is nadir CD4 count < 200 [41].…”

Evaluation of The Everyday Memory Questionnaire-Revised in Menopausal Population: Understanding the Brain Fog During Menopause

“…The Everyday Memory Questionnaire-Revised (EMQ-R) is a subjective measure of memory failure in everyday life, which was initially developed as a 35-item questionnaire to investigate the effects of closed-head injuries on memory performance. 22 Subsequently, this questionnaire was reduced by Royle and Lincoln 23 to a 13-item one (EMQ-R) and validated in several clinical populations, such as stroke 24 , chronic pain 25 and HIV 26 and non-clinical populations, such as community younger and older adults 27 , and Bosnian/Serbian healthy adults 28 . Although the item loadings were slightly different in these studies, two main factors of the EMQ-R were consistently observed with one factor relating to memory retrieval and another focusing on attentional process, suggesting that the EMQ-R may serve as a better option to measure brain fog due to this bifactor structure ( Retrieval and Attentional ).…”