Defining cognitive impairment in people-living-with-HIV: the POPPY study

BMC Infectious Diseases

Research Article

Jaime H. Vera¹  Marta Boffito²  Jonathan Underwood³  Alan Winston³  Jane Anderson⁴  Frank A. Post⁵  Ian Williams⁶  Davide De Francesco⁷  Caroline A. Sabin⁷  Patrick W. G. Mallon⁸  Memory Sachikonye⁹ 

[1] Brighton and Sussex Medical School, Brighton, UK;Chelsea and Westminster Healthcare NHS Foundation Trust, London, UK;Division of Infectious Diseases, Imperial College London, London, UK;Homerton University Hospital, London, UK;King’s College London, London, UK;Mortimer Market Centre, UCL, London, UK;Research Department of Infection & Population Health, UCL - Royal Free Campus, London, UK;UCD School Of Medicine, Dublin, Ireland;UK Community Advisory Board, London, UK;

关键词: HIV;    Cognitive impairment;    Patient-reported cognitive symptoms;    Neurology;    HIV-associated neurocognitive disorder;   

DOI  :  10.1186/s12879-016-1970-8

 received in 2016-06-24, accepted in 2016-10-25,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundThe reported prevalence of cognitive impairment (CI) varies widely in cohorts of people living with HIV (PLWH); this may partly be due to the use of different diagnostic criteria. Agreement between diagnostic criteria of CI, the optimal definition to use, and associations with patient-reported cognitive symptoms have not been fully investigated.MethodsTwo hundred ninety PLWH aged >50 years and 97 matched negative controls completed a detailed assessment of cognitive function and three questions regarding cognitive symptoms. Age- and education-adjusted test scores (T-scores) determined if subjects met the following definitions of CI: Frascati, global deficit score (GDS) and the multivariate normative comparison (MNC) method.ResultsPLWH were more likely than controls to meet each definition of CI (ORs were 2.17, 3.12 and 3.64 for Frascati, GDS and MNC, respectively). Agreement of MNC with Frascati and GDS was moderate (Cohen’s k = 0.42 and 0.48, respectively), whereas that between Frascati and GDS was good (k = 0.74). A significant association was found between all the three criteria and reporting of memory loss but not with attention and reasoning problems. The 41 (14 %) PLWH meeting all the three criteria had the lowest median global T-score (36.9) and highest rate of symptom reporting (42 %).ConclusionsDifferent CI criteria show fair diagnostic agreement, likely reflecting their ability to exclude CI in the same group of individuals. Given the lower overall cognitive performance and higher rates of symptom reporting in those meeting all three criteria of CI, further work assessing this as a definition of CI in PLWH is justified.

【 授权许可】

CC BY   
© The Author(s). 2016