Table 2.
Study outcome in literature on screening tools for HIV-associated neurocognitive disorders.
| Study (Author; Location) | Sample size (total; by group) | Impairment evaluated (type(s); classification system) | Tool characteristics (person can administer; time to administer; materials needed) | Reference test | Reference test details (size of battery; objective assessment; domains assessed; language of administration) | Sensitivity; Specificity | Main findings |
| HIV Dementia Scale (HDS) | |||||||
| Bottiggi et al. [18]; Kentucky, USA | 46 | Types: MCMD, HAD, Neurocognitive Deficits or Impairment (memory, attention, psychomotor, and construction); Classification: 1991 | Person: NR; Time: NR; Materials: NR | NP battery | Size: long; Objective: NR; Domains: Intelligence, attention/concentration, memory, language, executive functioning, visuo-spatial, speed of processing, motor; Language: English | Cut-off ≤10: Sensitivity: 0.36; Specificity: 0.94; | HDS is not efficient in predicting the presence of subtle and mild HIV-dementia. |
| Carey et al. [19]; San Diego, USA | 190 | Type: NP impaired and unimpaired; Classification: DSM-IV 1994, AAN 1991, Grant and Atkinson 1995 | Person: NR; Time: 5 min; Materials: NR | NP battery | Size: long; Objective: NR; Domains: Intelligence, attention/concentration, memory, language, executive functioning. visuo-spatial, speed of processing, motor; Language: English | Cut-off <11: Sensitivity: 0.09; Specificity: 0.98; | HDS is less accurate than paired NP test combinations- Hopkins Verbal Learning Test Revised (HVLTR; Total Recall) and the Grooved Pegboard Test nondominant hand (PND) pair, and the HVLTR and WAIS-III Digit Symbol (DS) subtest pair in classifying HIV-positive participants as NP impaired or not. |
| Ganasen et al. [24], Western Cape, South Africa | 474 | Type: NP impaired and unimpaired; Classification: MMSE used as the gold standard | Person: NR; Time: NR; Materials: NR | Mini-Mental State Examination (MMSE) | Size: short; Objective: NR; Domains: Attention/concentration, memory, motor; Language: Xhosa, Afrikaans | Cut-off ≤10: Sensitivity: 0.80; Specificity: 0.80; | HDS and MMSE were significantly correlated and showed significant agreement. Nonetheless, the HDS identified more participants who demonstrated cognitive impairment than the MMSE. HDS cut-off of ≤10 yielded a sensitivity of 80%, specificity of 80% and discriminated between the presence and absence of cognitive impairment 90% of the time. |
| Lyon et al. [31]; Washington, DC, USA | 71 | Type: HAD, HIV encephalopathy in adolescents; Classification: 1991 | Person: NR; Time: 10 min; Materials: NR | ANI 1991 Criteria | Size: NR; Objective: NR; Domains: Intelligence, attention/memory, language. Language: NR | Cut-off of ≤10: Sensitivity: 0.83; Specificity: 0.79; Cut-off of ≤9: Sensitivity: 0.88; Specificity: 0.83; | No statistically significant differences in sensitivity and specificity between the HDS and MMSE. Using standard cut-offs, HDS had 83% sensitivity and 79% specificity, although MMSE had 50% sensitivity and 92% specificity. The optimal cut-off score for the HDS, producing the highest sensitivity and specificity, was ≤9, providing 88% sensitivity and 83% specificity (87% correct classification). |
| Morgan et al. [34]; San Diego, California | 317; 135 (HIV+), 182 (HIV-) | Type: ANI, MCMD, HAD; Classification: 1991 | Person: NR; Time: 5–10 min; Materials: NR | Modified AAN 1991 Criteria and Grant and Atkinson 1995 Criteria | Size: long; Objective: Yes; Domains: NR; Language: NR | Demographically adjusted T-score <40: Sensitivity: 0.71; Specificity: 0.74; Raw cut-off score ≤10: Sensitivity: 0.17; Specificity: 0.94; | In comparison to the traditional HDS cut-off score (raw score total ≤10), use of the demographically adjusted normative standards significantly improved the sensitivity (from 17% to 71%) and overall classification accuracy (increasing the odds ratio from 3 to approximately 6). The application of demographically adjusted normative standards on the HDS improves the clinical applicability and accuracy. |
| Power et al. [6]; Baltimore, USA | 130 | Type: HAD; Classification: 1991 | Person: NR; Time: NR; Materials: NR | Memorial Sloan Kettering Dementia Evaluation; Mini-Mental State Exam (MMSE); Grooved Pegboard (PB) | Size: short; Objective: NR; Domains: Attention/ concentration, memory, executive functioning, motor; Language: English | Cut-off ≤10: Sensitivity: 0.80; Specificity: 0.91; | HDS demonstrated greater efficiency in identifying HIV dementia than Grooved Pegboard and the Mini-Mental State Examination. |
| Richardson et al. [38]; Boston area, USA | 40 | Types: Neurocognitive Deficit or Impairment (impairment in attention and concentration, psychomotor functioning, behavioural inhibition, constructional praxis); Classification: Performance at least 2 standard deviation units below established norms on one or more independent NP measures in two or more domains of functioning | Person: NR; Time: 10 min; Materials: NR | NP battery | Size: Medium; Objective: Yes; Domains: Memory, executive functioning, motor; Language: English | Cut-off ≤10: Sensitivity: 0.55; Specificity: 0.75; | HDS prediction resulted in modest sensitivity and moderate specificity. In ROC curve analysis, area under the curve was only modestly better than chance (0.58). Optimal cut-off for the HDS is ≤10. |
| Simioni et al. [40], Geneva, Switzerland | 100 (50 with cognitive complaints, 50 without cognitive complaints) | Types: ANI, MND, HAD; Classification: 2007 | Person: NR; Time: NR; Materials: NR | NP battery | Size: Medium; Objective: No; Domains: Intelligence, attention/concentration, memory, language, executive functioning, speed of processing, motor; Language: NR | Cut-off 10: Sensitivity: 0.54; Specificity: 0.96; Cut-Off 14: Complaining: Sensitivity 0.83; Specificity: 0.63; Noncomplaining: Sensitivity: 0.88; Specificity: 0.67; | Prevalence of HAND is high even in long-standing aviremic HIV-positive patients. HAND without functional repercussion in daily life is most frequent. Cut-off of 14 points or less seemed to provide a useful tool to screen for HANDs. |
| Smith et al. [42]; USA | 90 | Type: Neurocognitive Deficit or Impairment (subtle HIV-related cognitive dysfunction); Classification: Cognitive ‘abnormality’ defined as performance that deviated at least 2 SD units below established norms on at least two independent NP measures | Person: NR; Time: NR (noted ‘brief’); Materials: NR | NP battery | Size: Medium; Objective: No; Domains: Intelligence, memory, executive functioning, visuo-spatial, speed of processing, motor; Language: English | Cut-off ≤10: Sensitivity: 0.39; Specificity: 0.85; | HDS lacks sufficient sensitivity to screen for NP abnormality beyond frank dementia. Intact performance (i.e. performance above established cut-off levels) contributes to a significant number of false-negative errors, suggesting need for NP battery for subtle neurocognitive deficits. |
| Von Giesen et al. [43]; Dusseldorf, Germany | 266; 55 (mildly demented), 211 (not demented) | Types: mild dementia, no dementia; Classification: Mild dementia (HDS score ≤10), No dementia (HDS score >10) | Person: NR; Time: NR (noted ‘brief’); Materials: NR | NP battery | Size: short; Objective: NR; Domains: Motor; Language: German | Sensitivity: NR; Specificity: NR; | Patients with mild dementia showed significant slowing of most rapid alternating movement (MRAM) and significantly prolonged contraction time compared to nondemented patients. Motor performance correlated significantly with time-dependent HDS subscores for psychomotor speed and construction. |
| Wojna et al. [44]; Puerto Rico, USA | 96; 60 (HIV+), 36 (HIV-) | Types: Asymptomatic cognitive impairment, and symptomatic impairment (MCMD, HAD); Classification: modified 1991 | Person: NR; Time: NR (noted ‘rapid’); Materials: NR | NP battery | Size: Medium; Objective: Yes; Domains: Intelligence, memory, executive functioning, speed of processing, motor. Language: Spanish | Cut-off ≤12: Sensitivity: 0.63; Specificity: 0.84; Cut-off ≤13: Sensitivity: 0.87; Specificity: 0.46; | HDS-Spanish total score and subscores for psychomotor speed and memory recall showed a significant difference between HIV-negative women and HIV-positive women with dementia and between HIV-positive women with normal cognition and with dementia. Optimal cut-off point was ≤13. |
| International HIV Dementia Scale | |||||||
| Joska et al. [28]; Cape Town, South Africa | 190; 96 (HIV+); 94 (HIV-) | Types: ANI, MND, HAD; Classification: 2007 | Person: NR; Time: NR; Materials: NR | NP battery | Size: Medium; Objective: No; Domains: Attention/concentration, memory, executive function, visuo-spatial, motor; Language: isiXhosa, Afrikaans | Cut-off of 10: Sensitivity = 0.45; Specificity = 0.79; | In ART-naive sample, HIV-positive individuals displayed greater impairment than HIV-negative individuals on IHDS and range of NP tests. With ROC analysis, the area under curve was 0.64. These data suggest that the IHDS may have limitations as a tool to screen for HAD in South Africa. |
| Muniyandi et al. [64]; Thanjavur, India | 33 | Type: ANI, MND, HAD; Classification: 2007 | Person: NR; Time: NR; Materials: NR | NP battery | Size: NR; Objective: Yes; Domains: NR; Language: NR | NR | Tests that assess cognitive and motor speed may be more helpful than clinical psychiatric interview to spot the AIDS patients who have cognitive impairment. The International HIV Dementia Scale was the most sensitive instrument. |
| Sacktor et al. [7]; Uganda/ Baltimore, USA | 247; 66 (HIV+ USA), 81 (HIV+ Uganda), 100 (HIV- control, Uganda) | Type: HAD; Classification: 1991 | Person: Non-Neurologist; Time: 2–3 min; Materials: Watch with a second hand | Memorial Sloan Kettering Dementia Staging; NP battery | Size: Medium; Objective: Yes; Domains: Attention/concentration, memory, language, executive functioning, speed of processing, motor; Language: English, Luganda | Cut-off ≤10: USA: Sensitivity: 0.80; Specificity: 0.57; Uganda: Sensitivity: 0.80; Specificity: 0.55; | IHDS may be a useful screening test to identify individuals at a risk for HIV dementia in both industrialized and developing world. Full NP testing should be performed to confirm diagnosis of HIV dementia. |
| Singh et al. [41]; Durban, South Africa | 20 | Type: Neurocognitive Deficit or Impairment (moderate and severe); Classification: Moderate – Beyond the norms on at least 2 tests; Severe – three or more tests abnormal | Person: Nonspecialist; Time: 2–3 min; Materials: None | NP battery | Size: short; Objective: NR; Domains: Attention, memory, executive functioning, motor; Language: English, isiZulu | Cut-off of 10: Specificity = 0.88; Sensitivity = 0.50; | Low specificity may limit clinical utility of IHDS. Research needed to verify the high burden on neurocognitive impairment among people with low CD4+ cell count. Larger study needed to validate IHDS in South Africa. |
| CogState | |||||||
| Cysique et al. [20]; Sydney, Australia | 81 | Types: ADC; Neurocognitive Deficits or Impairments (psychomotor speed, working memory, attention, learning); Classification System: ≤−2 SD in 2 of 14 neuropsychological measures (Cysique 2004) | Person: NR; Time: 10–15 min; Materials: Desktop computer | NP battery | Size: long; Objective: Yes; Domains: Intelligence, attention/concentration, memory, language, executive functioning, visuo-spatial, motor; Language: English | Sensitivity: 0.81; Specificity: 0.70; | Study supports utility of brief computerized battery in detection of HIV-associated neurocognitive impairment. Good agreement between standard neuropsychological tests and the CogState indices in identifying neurocognitive impairment. |
| Maruff, 2009; Melbourne, Australia | 293; 20 (ADC), 20 (ADC controls); 253 healthy adults | Type: ADC; Definition: Price and Brew, 1988 | Person: NR; Time: 8–10 min; Materials: Personal computer | NP battery | Size: Medium; Objective: NR; Domains: Memory, visuo-spatial processing, motor; Language: English | Sensitivity: NR; Specificity: NR; | Brief CogState battery has adequate construct validity and is sensitive to subtle cognitive impairment in ADC. Recommends that assessment of attention, processing speed, memory and working memory based only on CogState can support solely on broad conclusions. |
| Overton et al. [35]; St. Louis, USA | 46 | Type: Neurocognitive Deficit or Impairment (mild to moderate impairment); Classification: Carey 2004 | Person: NR; Time: 12–15 min: Materials: Computer and computer program | NP battery | Size: Medium; Objective: NR; Domains: Attention/concentration, memory, language, executive functioning, motor; Language: English | GDS ≥0.5: Sensitivity: NR; Specificity: NR; | Measures of both simple detection tests and identification task correlated with GDS and had the highest level of correlation with tests in CHARTER battery. Other tests correlated poorly with NP testing. Composite score of five tests (significant in ROC analyses) correctly classified 90% of individuals according to impairment. |
| Mini-Mental State Examination (MMSE) | |||||||
| Lyon et al. [31]; Washington, DC, USA | 71 | Type: HIV-Encephalopathy in adolescents; Classification: 1991 | Person: NR; Time: 10 min; Materials: NR | ANI 1991 Criteria | Size: NR; Objective: NR; Domains: NR; Language: NR | Cut-off <24; Sensitivity: 0.50; Specificity: 0.92; | MMSE identified 3 of 6 cases of encephalopathy. HDS appeared to be more clinically useful. |
| Muniyandi et al. [64]; Thanjavur, India | 33 | Type: ANI, MND, HAD; Classification: 2007 | Person: NR; Time: NR; Materials: NR | NP battery | Size: NR; Objective: Yes; Domains: NR; Language: NR | NR | Tests that assess cognitive and motor speed may be more helpful than clinical psychiatric interview to spot the AIDS patients who have cognitive impairment. The International HIV Dementia Scale was the most sensitive instrument. |
| Power et al. [6]; Baltimore, USA | 130 | Type: HAD; Classification: 1991 | Person: NR; Time: NR; Materials: NR | Memorial Sloan Kettering Dementia Evaluation; HIV Dementia Scale (HDS); Grooved Pegboard (PB) | Size: short; Objective: NR; Domains: Attention/ concentration, memory, executive functioning, motor; Language: English | Cut-off ≤28: Sensitivity: 0.50; Specificity: 0.88; | MMSE was less efficient at identifying HIV Dementia than the HDS and the Grooved Pegboard. |
| Brief Neurocognitive Screen (Component Neuroscreen) | |||||||
| Ellis et al. [22]; 15 sites, USA | 301 | Type: MCMD, HAD, Neurocognitive Deficits or Impairment (speed of information processing, mental flexibility, working memory); Classification: 1991 Classification | Person: Non-neurologist; Time: 12–15 min; Materials: NR | NP battery | Size: Medium; Objective: Yes; Domains: Attention/concentration, memory, language, speed of processing, motor; Language: English | Sensitivity: 0.65; Specificity: 0.72; | Designed to estimate the frequency of HIV-associated neurocognitive disorders. In ROC, when compared with NP battery, the area under the curve was 0.74. Yields (Neuroscreen as a whole) a substantial number of false positives and negatives so more useful for tracking prevalence in large cohorts rather than individual patients. |
| Bender Gestalt Test (BGT) | |||||||
| Muniyandi et al. [64]; Thanjavur, India | 33 | Type: ANI, MND, HAD; Classification: 2007 | Person: NR; Time: NR; Materials: NR | NP battery | Size: NR; Objective: Yes; Domains: NR; Language: NR | NR | Tests that assess cognitive and motor speed may be more helpful than clinical psychiatric interview to spot the AIDS patients who have cognitive impairment. The International HIV Dementia Scale was the most sensitive instrument. |
| California Computerized Assessment Package (CalCAP) Mini Battery | |||||||
| Gonzalez et al. [26]; California, USA | 82 | Type: Neurocognitive Deficits (normal, mild, mild-moderate, moderate, moderate-severe, severe) or Impairments (attention and speed of information processing, abstraction, learning); Heaton 1995 | Person: NR; Time: 10 min; Materials: Computer | NP battery | Size: long; Objective: No; Domains: Attention/concentration, memory, executive functioning, visuo-spatial, speed of processing, motor; Language: English | Cut-off D-score of ≥0.5: Sensitivity: 0.68; Specificity: 0.77; | Traditional NP batteries and computerized reaction time tests do not measure the same thing. They are not interchangeable in examining HIV-related NP impairment. |
| Coin Rotation Test | |||||||
| Minor et al. [33]; Louisiana, USA | 204 | Type: Neurocognitive Deficits or Impairment (psychomotor performance); Classification: NR | Person: not specified; Time: 1 min; Materials: NR (infer coin and timer) | Psychomotor speed subscale of the modified HIV Dementia Scale (MHDS-PS). | Size: short; Objective: NR; Domains: Memory, executive functioning, motor; Language: English | Cut-off of 20 Rotations: Sensitivity: 0.72; Specificity: 0.61; | Good convergent validity between Coin Rotation Test and Modified HDS. Gender did not significantly affect CRT performance but did affect modified HDS performance. CRT performance was less affected by education than MHDS performance. |
| The Computer Assessment of Mild Cognitive Impairment | |||||||
| Becker et al. [17]; USA | 59; 29 (HIV+), 30 (HIV-) | Type: Neurocognitive Deficits or Impairment (normal, borderline, impaired); Classification: Global Impairment Rating (Woods, 2004) | Person: Health Professionals; Time: 20 min; Materials: Tablet with touch screen | NP battery | Size: long; Objective: NR; Domains: Memory, language, executive functioning, visuo-spatial, speed of processing, motor; Language: English | Sensitivity: 0.72; Specificity: 0.97; | Detected mild impairment and median stability over 12 and 24 weeks of follow-up was 0.32 and 0.46 (did not differ as a function of serostatus). Discriminate functional analysis (6 CAMCI scores) correctly classified 90% of subjects. |
| Four-item scale from Health Survey; Six-item scale from MOS | |||||||
| Revicki et al. [37]; Baltimore, USA | 162 (baseline); 131 follow-up | Type: Mild, Severe impairment; Classification: TMT manual (Reitan, 1992) | Person: NR; Time: less than 2 min; Materials: NR | Trail-Making Test (TMT) | Size: short; Objective: No; Domains: Executive functioning, speed of processing, motor; Language: English | Sensitivity: NR; Specificity: NR; | Logistic regression analysis showed both four-item version (CF4) included in the HIV Health Survey and the complete six-item scale (CF6) from the Medical Outcomes Study - MOS predicted mild cognitive impairment based on TMT scores (P = 0.046–0.008) and severe cognitive impairment based on TMT scores (P = 0.0012–0.0003). Baseline significant differences in mean CF6 and CF4 scores for mildly impaired compared with less than mildly impaired and severely impaired and less than severely impaired. |
| Grooved Pegboard | |||||||
| Power et al. [6]; Baltimore, USA | 130 | Type: HAD; Classification: 1991 | Person: NR; Time: NR; Materials: NR | Memorial Sloan Kettering Dementia Evaluation; HIV-Dementia Scale (HDS); Mini-Mental State Exam (MMSE); | Size: short; Objective: NR; Domains: Attention/concentration, memory, executive functioning, motor; Language: English | Cut-off ≥90 s: Sensitivity: 0.91; Specificity: 0.82; | Was efficient in detecting HAD (86%) compared with the HDS (84%) and MMSE (72%). |
| Brief Cognitive Screen (BCS) – memory subtest, verbal fluency items and conflicting stimulus test of the High Sensitivity Cognitive Screen (HSCS) | |||||||
| Fogel [23]; 3 locations, USA | 156 | Type: Neurocognitive Deficits or Impairment (memory, verbal fluency, conflicting stimulus); Classification: Abnormality on the Brief Dementia Screen | Person: NR; Time: NR; Materials: NR | Standardized Dementia Screen (registration and delayed memory for three simple words, months in reverse, five serial sevens, and orientation to month and year) | Size: short; Objective: No; Domains: Memory, language, orientation; Language: English | Sensitivity: NR; Specificity: NR; | Patients with abnormal scores on the Brief Cognitive Screen showed greater symptoms and functional impairment. |
| HIV Dementia Diagnostic Test | |||||||
| Kwasa et al. [30]; Kisumu, Kenya | 26; 14 (ANI, MND), 6 (HAD) | Type: ANI, MDN,HAD; Classification: 2007 | Person: Nonphysician health-care worker; Time: NR; Materials: NR | NP battery | Size: Medium; Objective: Yes; Domains: Attention/concentration, memory, language, executive functioning, speed of processing, motor; Language: English, Dhulou | Cut-off ≤22: Sensitivity: 0.63; Specificity: 0.67; | Moderate sensitivity and specificity for HAD. Reliability was poor, suggesting that substantial training and formal evaluations of training adequacy will be critical. |
| Hopkins verbal test –revised – and Grooved Pegboard Test Nondominant Hand | |||||||
| Carey et al. [19]; San Diego, USA | 190 | Type: Neurocognitive Deficits or Impairment (NP impaired or unimpaired) Classification: DSM-IV 1994, AAN 1991, Grant and Atkinson 1995 | Person: Trained psychometrist; Time: 5 min; Materials: NR | NP battery | Size: long; Objective: NR; Domains: Intelligence, attention/concentration, memory, language, executive functioning, visuo-spatial, speed of processing, motor; Language: English | Sensitivity: 0.78; Specificity: 0.85; | The combination of Hopkins Verbal Test-Revised and Grooved Pegboard Test Nondominant Hand was more accurate than the HIV Dementia Scale (HDS) in classifying HIV-positive participants as NP impaired or unimpaired. |
| Hopkins Verbal Learning Test/WAIS-III Digit Symbol | |||||||
| Carey et al. [19]; San Diego, USA | 190 | Type: Neurocognitive Deficits or Impairment (NP impaired and unimpaired) Classification: DSM-IV 1994, AAN 1991, Grant and Atkinson 1995 | Person: Trained Psychometrist; Time: 5 min; Materials: NR | NP battery | Size: long; Objective: NR; Domains: Intelligence, attention/concentration, memory, language, executive functioning, visuo-spatial, speed of processing, motor; Language: English | Sensitivity: 0.75; Specificity: 0.92; | The combination of Hopkins Verbal Test-Revised and WAIS-III Digit Symbol (DS) subtest was more accurate than the HIV Dementia Scale (HDS) in classifying HIV-positive participants as NP impaired or unimpaired. |
| Medical Outcome Study HIV (MOS-HIV) Health Survey | |||||||
| Knippels et al. [29]; the Netherlands and Flanders, Belgium | 82 | Type: Neurocognitive Deficits or Impairment (neuropsychological impairment); Classification: NR | Person: Completed at home; Time: NR; Materials: Questionnaire | NP battery | Size: Medium; Objective: No; Domains: Attention/concentration, memory, language, executive functioning, visuo-spatial, motor; Language: Dutch | Sensitivity: NR; Specificity: NR; | Showed significant associations with NP test performance overall and, specifically, with the domains of abstraction, language, visuo-spatial abilities (controlling for CD4+ cell count and CDC disease stage). Trend towards significance in memory domain. Seems particularly sensitive to changes in NP test performance in early HIV infection. |
| Mental Alternation Test | |||||||
| Jones et al. [27]; Baltimore, USA | 62 | Type: Neurocognitive Deficits or Impairment (orientation, memory, concentration, language, praxis, psycho or speed, sequencing ability); Classification: abnormal performance on MMSE and Trailmaking (Crum 1993, Nornstein, 1985) | Person: NR; Time: 60 s; Materials: NR; | Mini-Mental State Examination; Trailmaking Part A and B | Size: short; Objective: NR; Domains: Intelligence, attention/concentration, memory, language, executive functioning, speed of processing; Language: English | With MMSE: Sensitivity: 0.95; Specificity: 0.79; With Trailmaking: Sensitivity: 0.78; Specificity: 0.93; | Scores correlated significantly with MMSE and Trailmaking Test Part B scores when controlled for confounders. ROC curve showed cut-off of 15 yielded best results for detection of abnormal performance on MMSE and Trailmaking Test Part B. |
| Motor Battery (Timed Gait, Grooved Pegboard, Finger-tapping) | |||||||
| Parsons et al. [36]; USA | 361 | Type: Neurocognitive Deficits or Impairment (attention, executive, figural memory, verbal memory, language); Classification: NR | Person: NR; Time: NR (noted ‘brief’); Materials: NR | NP battery | Size: long; Objective: NR; Domains: Attention/concentration, memory, language, executive functioning, visuo-spatial, speed of processing, motor; Language: English | Cut-off of −0.42: Sensitivity: 0.79; Specificity: 0.76; | Significant correlation with comprehensive battery (52% variance). Increased variance to 73% when Digit Symbol and Trailmaking added. Motor battery may have broader utility to diagnose and monitor HIV-related neurocognitive disorder in international settings. |
| Prospective and Retrospective Memory Questionnaire (PRMQ) | |||||||
| Garvey et al. [25]; London, UK | 45 | Types: Neurocognitive Deficits or Impairment (asymptomatic neurocognitive impairment aNCI, memory); Classification: aNCI- performance score more than 1 SD below the normative mean in at least 2 domains of CogState. | Person: NR; Time: 10 min; Materials: questionnaire, writing utensil | CogState | Size: short; Objective: NR; Domains: Attention/concentration, memory, executive functioning, motor, learning; Language: English | Sensitivity: NR; Specificity: NR; | No statistically significant associations between PRMQ and CogState; questionnaire should not be used as a screening tool. Association between PRMQ and set-shifting task of CogState; questionnaire able to capture part of the executive function deterioration in HIV-associated NCI. |
| Screening Algorithm | |||||||
| Cysique et al. [21]; Sydney, Australia | 127; 97 (HIV+), 30 (HIV-) | Types: Neurocognitive Deficits or Impairment (HAND); Classification: 2007 | Person: Clinical Individual; Time: 3 min; Materials: patient's clinical characteristics | NP battery | Size: long; Objective: Yes; Domains: Intelligence, attention/concentration, memory, language, speed of processing, motor, reasoning; Language: English | Sensitivity: 0.78; Specificity: 0.70; | Good overall prediction accuracy and specificity. Proved useful to identify HIV-infected patients with advanced disease at a high risk of HAND who require more formal assessment. Recommended for HIV-infected white men with advanced disease. |
| Timed Gait Test | |||||||
| Robertson et al. [39]; ACTG sites all over the world | 1549; 1122 (AIDS), 113 (symptomatic), 165 (asymptomatic), 87 (HIV-) | Type: ADC; Classification: Neurologic History (Robertson, 1997) | Person: NR; Time: NR; Materials: Stopwatch, recording sheet | ADC Staging; NP battery | Size: NR; Objective: Yes; Domains: Memory, language, executive functioning, visuo-spatial processing, motor; Language: English | Sensitivity: 0.83; Specificity: 0.59; | Good sensitivity and moderate specificity for detection of ADC. Abnormal Timed Gait scores were also significantly correlated with abnormal scores on neurological and neuropsychological evaluations. Cutting scores on the Timed Gait procedure resulted in reasonably good classification rates of ADC staging, especially for use as a screening tool. |
| Wechster Memory Scale | |||||||
| Muniyandi et al. [64]; Thanjavur, India | 33 | Type: ANI, MND, HAD; Classification: 2007 | Person: NR; Time: NR; Materials: NR | NP battery | Size: NR; Objective: Yes; Domains: NR; Language: NR | NR | Tests that assess cognitive and motor speed may be more helpful than clinical psychiatric interview to spot the AIDS patients who have cognitive impairment. The International HIV Dementia Scale was the most sensitive instrument. |
Criteria for Battery Size: ‘short’ battery – criterion was defined by testing that took <30 min to administer; ‘medium’ battery – criterion was defined by testing that took 30–90 min to administer; and ‘long and comprehensive’ battery – criterion was defined by testing that took >90 min to administer. ADC, AIDS Dementia Complex; aNCI, asymptomatic neurocognitive impairment; ANI, asymptomatic neurocognitive disorder; HAD, HIV-associated dementia; MCMD, minor cognitive-motor disorder; MND, mild neurocognitive disorder; NP, neuropsychological; NR, not reported.