Identifying risk factors for HIV-associated neurocognitive disorders using the international HIV dementia scale

Sara Cross, Nur Önen, Amber Gase, Edgar Turner Overton, Beau M. Ances

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

HIV-associated neurocognitive disorders (HAND) persist despite great advancements in combination antiretroviral therapy (cART). The gold standard for diagnosing cognitive impairment consists of a time-consuming neuropsychological battery of tests given by a trained neuropsychologist, however in the outpatient HIV clinic this is not feasible. The International HIV Dementia Scale (IHDS) was developed to help identify individuals with cognitive impairment in the outpatient setting. The IHDS is moderately sensitive for detecting more symptomatic forms of HAND but sensitivity has been shown to be poor in mild impairment. The IHDS has not been evaluated in developed countries in large cohort populations. We conducted a prospective cross-sectional study of only HIV+ individuals in an urban clinic and evaluated the prevalence of HAND and associated risk factors for cognitive impairment using the IHDS. A total of 507 HIV+ individuals participated in the study of which the majority were male (65 %) and African American (68 %); and 41 % had cognitive impairment. On multivariate analysis, African American race (p = 2.21), older age (p = 1.03), high school education or less (p = 2.03) and depression (p = 1.05) were associated with cognitive impairment. The high prevalence of HAND in this group suggests that more severe forms of HAND persist despite cART. Identified risk factors were non-HIV-related and suggest that environmental and sociodemographic factors have a significant impact on cognitive functioning and should be given more attention. The IHDS should be further evaluated in large cohort HIV+ and HIV- populations in the United States, as there remains a significant need to identify an effective brief screening tool for cognitive impairment.

Original languageEnglish (US)
Pages (from-to)1114-1122
Number of pages9
JournalJournal of Neuroimmune Pharmacology
Volume8
Issue number5
DOIs
StatePublished - Dec 1 2013

Fingerprint

AIDS Dementia Complex
HIV
African Americans
Neurocognitive Disorders
Neuropsychological Tests
Ambulatory Care Facilities
Developed Countries
Population
Cognitive Dysfunction
Outpatients
Multivariate Analysis
Cross-Sectional Studies

All Science Journal Classification (ASJC) codes

  • Neuroscience (miscellaneous)
  • Immunology and Allergy
  • Immunology
  • Pharmacology

Cite this

Identifying risk factors for HIV-associated neurocognitive disorders using the international HIV dementia scale. / Cross, Sara; Önen, Nur; Gase, Amber; Overton, Edgar Turner; Ances, Beau M.

In: Journal of Neuroimmune Pharmacology, Vol. 8, No. 5, 01.12.2013, p. 1114-1122.

Research output: Contribution to journalArticle

Cross, Sara ; Önen, Nur ; Gase, Amber ; Overton, Edgar Turner ; Ances, Beau M. / Identifying risk factors for HIV-associated neurocognitive disorders using the international HIV dementia scale. In: Journal of Neuroimmune Pharmacology. 2013 ; Vol. 8, No. 5. pp. 1114-1122.
@article{a6749e00f3d2496498e3853f259bb655,
title = "Identifying risk factors for HIV-associated neurocognitive disorders using the international HIV dementia scale",
abstract = "HIV-associated neurocognitive disorders (HAND) persist despite great advancements in combination antiretroviral therapy (cART). The gold standard for diagnosing cognitive impairment consists of a time-consuming neuropsychological battery of tests given by a trained neuropsychologist, however in the outpatient HIV clinic this is not feasible. The International HIV Dementia Scale (IHDS) was developed to help identify individuals with cognitive impairment in the outpatient setting. The IHDS is moderately sensitive for detecting more symptomatic forms of HAND but sensitivity has been shown to be poor in mild impairment. The IHDS has not been evaluated in developed countries in large cohort populations. We conducted a prospective cross-sectional study of only HIV+ individuals in an urban clinic and evaluated the prevalence of HAND and associated risk factors for cognitive impairment using the IHDS. A total of 507 HIV+ individuals participated in the study of which the majority were male (65 {\%}) and African American (68 {\%}); and 41 {\%} had cognitive impairment. On multivariate analysis, African American race (p = 2.21), older age (p = 1.03), high school education or less (p = 2.03) and depression (p = 1.05) were associated with cognitive impairment. The high prevalence of HAND in this group suggests that more severe forms of HAND persist despite cART. Identified risk factors were non-HIV-related and suggest that environmental and sociodemographic factors have a significant impact on cognitive functioning and should be given more attention. The IHDS should be further evaluated in large cohort HIV+ and HIV- populations in the United States, as there remains a significant need to identify an effective brief screening tool for cognitive impairment.",
author = "Sara Cross and Nur {\"O}nen and Amber Gase and Overton, {Edgar Turner} and Ances, {Beau M.}",
year = "2013",
month = "12",
day = "1",
doi = "10.1007/s11481-013-9505-1",
language = "English (US)",
volume = "8",
pages = "1114--1122",
journal = "Journal of NeuroImmune Pharmacology",
issn = "1557-1890",
publisher = "Springer New York",
number = "5",

}

TY - JOUR

T1 - Identifying risk factors for HIV-associated neurocognitive disorders using the international HIV dementia scale

AU - Cross, Sara

AU - Önen, Nur

AU - Gase, Amber

AU - Overton, Edgar Turner

AU - Ances, Beau M.

PY - 2013/12/1

Y1 - 2013/12/1

N2 - HIV-associated neurocognitive disorders (HAND) persist despite great advancements in combination antiretroviral therapy (cART). The gold standard for diagnosing cognitive impairment consists of a time-consuming neuropsychological battery of tests given by a trained neuropsychologist, however in the outpatient HIV clinic this is not feasible. The International HIV Dementia Scale (IHDS) was developed to help identify individuals with cognitive impairment in the outpatient setting. The IHDS is moderately sensitive for detecting more symptomatic forms of HAND but sensitivity has been shown to be poor in mild impairment. The IHDS has not been evaluated in developed countries in large cohort populations. We conducted a prospective cross-sectional study of only HIV+ individuals in an urban clinic and evaluated the prevalence of HAND and associated risk factors for cognitive impairment using the IHDS. A total of 507 HIV+ individuals participated in the study of which the majority were male (65 %) and African American (68 %); and 41 % had cognitive impairment. On multivariate analysis, African American race (p = 2.21), older age (p = 1.03), high school education or less (p = 2.03) and depression (p = 1.05) were associated with cognitive impairment. The high prevalence of HAND in this group suggests that more severe forms of HAND persist despite cART. Identified risk factors were non-HIV-related and suggest that environmental and sociodemographic factors have a significant impact on cognitive functioning and should be given more attention. The IHDS should be further evaluated in large cohort HIV+ and HIV- populations in the United States, as there remains a significant need to identify an effective brief screening tool for cognitive impairment.

AB - HIV-associated neurocognitive disorders (HAND) persist despite great advancements in combination antiretroviral therapy (cART). The gold standard for diagnosing cognitive impairment consists of a time-consuming neuropsychological battery of tests given by a trained neuropsychologist, however in the outpatient HIV clinic this is not feasible. The International HIV Dementia Scale (IHDS) was developed to help identify individuals with cognitive impairment in the outpatient setting. The IHDS is moderately sensitive for detecting more symptomatic forms of HAND but sensitivity has been shown to be poor in mild impairment. The IHDS has not been evaluated in developed countries in large cohort populations. We conducted a prospective cross-sectional study of only HIV+ individuals in an urban clinic and evaluated the prevalence of HAND and associated risk factors for cognitive impairment using the IHDS. A total of 507 HIV+ individuals participated in the study of which the majority were male (65 %) and African American (68 %); and 41 % had cognitive impairment. On multivariate analysis, African American race (p = 2.21), older age (p = 1.03), high school education or less (p = 2.03) and depression (p = 1.05) were associated with cognitive impairment. The high prevalence of HAND in this group suggests that more severe forms of HAND persist despite cART. Identified risk factors were non-HIV-related and suggest that environmental and sociodemographic factors have a significant impact on cognitive functioning and should be given more attention. The IHDS should be further evaluated in large cohort HIV+ and HIV- populations in the United States, as there remains a significant need to identify an effective brief screening tool for cognitive impairment.

UR - http://www.scopus.com/inward/record.url?scp=84891360925&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84891360925&partnerID=8YFLogxK

U2 - 10.1007/s11481-013-9505-1

DO - 10.1007/s11481-013-9505-1

M3 - Article

C2 - 24114509

AN - SCOPUS:84891360925

VL - 8

SP - 1114

EP - 1122

JO - Journal of NeuroImmune Pharmacology

JF - Journal of NeuroImmune Pharmacology

SN - 1557-1890

IS - 5

ER -