A novel computerized functional assessment for human immunodeficiency virus-associated neurocognitive disorder

Liana S. Rosenthal, Richard L. Skolasky, Richard T. Moxley, Heidi Vornbrock Roosa, Ola A. Selnes, Amy Eschman, Justin C. McArthur, Ned Sacktor

Research output: Contribution to journalArticle

Abstract

Human immunodeficiency virus (HIV)-associated neurocognitive disorder (HAND) is present in 30-60 % of HIV-positive (HIV+) individuals and can be assessed by neuropsychological testing and level of functional impairment. HAND diagnosis therefore requires accurate assessment of functional impairment. The Computer Assessment of Mild Cognitive Impairment (CAMCI) is a computer-based screening tool that includes performance-based measures of functional impairment. We sought to evaluate the CAMCI as a functional assessment tool in HAND. One hundred fourteen HIV+ patients and 38 HIV-negative (HIV-) patients underwent neuropsychological and CAMCI testing. Cognitive status for HIV+ subjects was classified using the Frascati criteria. HIV+ subjects grouped together and classified by cognitive impairment performed worse than HIV- subjects on several of the CAMCI tasks, including following directions to the supermarket (p = 0.05, p = 0.03), recalling which items to purchase (p = 0.01, p = 0.02), and remembering to stop at a supermarket (p < 0.01, p = 0.01) and the post office (p < 0.01, p = 0.03). After controlling for hepatitis C status and depression symptomatology, the tasks "following directions to the supermarket" and the "recalling which items to purchase" were no longer significant. The "remembering to run two separate errands" tasks retained their significance (p < 0.01 for both tasks). A subset of the CAMCI tasks therefore successfully differentiated HIV+ patients from HIV- individuals. Differences in hepatitis C status and depression symptomatology could account for some of the function assessment differences in the CAMCI. These results suggest the CAMCI could be a useful objective performance-based functional assessment in patients with HIV.

Original languageEnglish (US)
Pages (from-to)432-441
Number of pages10
JournalJournal of neurovirology
Volume19
Issue number5
DOIs
StatePublished - Oct 2013

    Fingerprint

Keywords

  • Assessment of cognitive disorders/dementia [38]
  • HIV [144]
  • HIV dementia [34]
  • Neuropsychological assessment [205]

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology
  • Cellular and Molecular Neuroscience
  • Virology

Cite this