TY - JOUR
T1 - A novel computerized functional assessment for human immunodeficiency virus-associated neurocognitive disorder
AU - Rosenthal, Liana S.
AU - Skolasky, Richard L.
AU - Moxley, Richard T.
AU - Roosa, Heidi Vornbrock
AU - Selnes, Ola A.
AU - Eschman, Amy
AU - McArthur, Justin C.
AU - Sacktor, Ned
N1 - Funding Information:
Study was supported by National Institutes of Health grants 1P30MH075673, MH71150, NS44807, and GCRC RR UL1RR025005. Psychology Software Tools, Inc. provided the CAMCI.
PY - 2013/10
Y1 - 2013/10
N2 - 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.
AB - 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.
KW - Assessment of cognitive disorders/dementia [38]
KW - HIV [144]
KW - HIV dementia [34]
KW - Neuropsychological assessment [205]
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U2 - 10.1007/s13365-013-0195-5
DO - 10.1007/s13365-013-0195-5
M3 - Article
C2 - 24081883
AN - SCOPUS:84885640869
SN - 1355-0284
VL - 19
SP - 432
EP - 441
JO - Journal of neurovirology
JF - Journal of neurovirology
IS - 5
ER -