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Diagnosing Symptomatic HIV-Associated Neurocognitive Disorders: Self-Report Versus Performance-Based Assessment of Everyday Functioning

Year: 2011
Type: article
Study design: Observational Study
Abstract: 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.
DOI: 10.1017/s135561771100141x
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, J. Hampton Atkinson, I. Grant
Institutions: San Diego State University, University of California San Diego, Washington University in St. Louis, Icahn School of Medicine at Mount Sinai, University of Washington, The University of Texas Medical Branch at Galveston, Johns Hopkins University
Language: English
Subfield: Virology
Open Access status: green
Funders: U.S. Department of Defense, U.S. Department of Veterans Affairs, University of Washington, Johns Hopkins University, National Institutes of Health, University of California, San Diego, Veterans Affairs San Diego Healthcare System, U.S. Navy, National Institute of Mental Health, National Institute on Drug Abuse
Awards: G25173860, CNS HIV Anti-Retroviral Therapy Effects Research (CHARTER), G3611395682, G6224456646, Training in Research on Addictions in Interdisciplinary NeuroAIDS (TRAIN), HIV Neurobehavioral Research Center
OpenAlex ID: W2164526701
FWCI: 3.294
Cites: 36
Cited by: 116
Related to: 10