Date Published:
2012 Jan

Publication Type:
Journal Article

Authors:

K. Blackstone
D.J. Moore
R.K. Heaton
D.R. Franklin
S.P. Woods
D.B. Clifford
A.C. Collier
C.M. Marra
B.B. Gelman
J.C. McArthur
S. Morgello
D.M. Simpson
M. Rivera-Mindt
R. Deutsch
R.J. Ellis
H. Atkinson
I. Grant

Secondary:
J Int Neuropsychol Soc

Volume:
18

Pagination:
79-88

Issue:
1

PMID:
22114912

URL:
https://pubmed.ncbi.nlm.nih.gov/22114912

DOI:
10.1017/S135561771100141X

Keywords:
Activities of Daily Living;Adult;Aged;CHARTER;Cognition Disorders;Cohort Studies;Depression;Female;HIV Infections;HN Protein;Humans;Immunoenzyme Techniques;Internal;Lipopolysaccharide Receptors;Logistic Models;Male;Middle Aged;Motor Activity;Neuropsychological Tests;Psychiatric Status Rating Scales;Self Report;Sensitivity and Specificity;Statistics, Nonparametric;Young Adult

Abstract:
<p>Three types of HIV-associated neurocognitive disorders (HAND) exist that are distinguished by presence and severity of impairment in cognitive and everyday functioning. Although well-validated neurocognitive measures exist, determining impairment in everyday functioning remains a challenge. We aim to determine whether Self-Report measures of everyday functioning are as effective in characterizing HAND as Performance-Based measures. We assessed 674 HIV-infected participants with a comprehensive neurocognitive battery; 233 met criteria for a HAND diagnosis by having at least mild neurocognitive impairment. Functional decline was measured via Self-Report and Performance-Based measures. HAND diagnoses were determined according to published criteria using three approaches to assess functional decline: (1) Self-Report measures only, (2) Performance-Based measures only, and (3) Dual-method combining Self-Report and Performance-Based measures. The Dual-method classified the most symptomatic HAND, compared to either singular method. Singular method classifications were 76% concordant with each other. Participants classified as Performance-Based functionally impaired were more likely to be unemployed and more immunosuppressed, whereas those classified as Self-Report functionally impaired had more depressive symptoms. Multimodal methods of assessing everyday functioning facilitate detection of symptomatic HAND. Singular Performance-Based classifications were associated with objective functional and disease-related factors; reliance on Self-Report classifications may be biased by depressive symptoms.</p>