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Diagnosing symptomatic HIV-associated neurocognitive disorders: Self-report versus performance-based assessment of everyday functioning

  • Author(s): Blackstone, K
  • Moore, DJ
  • Heaton, RK
  • Franklin, DR
  • Woods, SP
  • Clifford, DB
  • Collier, AC
  • Marra, CM
  • Gelman, BB
  • McArthur, JC
  • Morgello, S
  • Simpson, DM
  • Rivera-Mindt, M
  • Deutsch, R
  • Ellis, RJ
  • Hampton Atkinson, J
  • Grant, I
  • et al.

Published Web Location

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3882265/
No data is associated with this publication.
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. Copyright © 2011 INS. Published by Cambridge University Press.

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