Table 3.
Diagnostic classification of HIV-associated neurocognitive disorders over time
| Frascati Criteria (2007)19 | |
| ANI | Asymptomatic neurocognitive impairment |
| Neuropsychological performance at least 1 SD below demographically matched normative scores in at least 2 cognitive domains1. | |
| Cognitive impairment does not interfere with everyday functioning | |
| MND | Mild neurocognitive disorder |
| Neuropsychological performance at least 1 SD below demographically matched normative scores in at least 2 cognitive domains1. | |
| Cognitive impairment results in mild interference in daily functioning | |
| HAD | HIV-associated dementia |
| Neuropsychological performance at least 2 SD below demographically matched normative scores in at least 2 cognitive domains1. | |
| Cognitive impairment results in marked interference in daily functioning | |
| American Academy of Neurology (AAN) Criteria (2001)18 | |
| MCMD | Minor cognitive–motor disorder |
| Acquired abnormality in at least two of the following cognitive/motor/behavioral domains for >1 month verified by clinical neurologic examination or neuropsychological testing: impaired attention/concentration, mental slowing, impairment memory, slowed movements, impaired coordination, or personality change/irritability/emotional liability1. | |
| Disturbance from cognitive/motor/behavioral abnormalities causes mild impairment of work or activities of daily living | |
| HAD | HIV-associated dementia |
| Acquired abnormality in at least two of the following cognitive domains for >1 month causing impairment in work or activities of daily living: attention/concentration, speed of information processing, abstraction/reasoning, visuospatial skills, memory/learning, speech/language1. | |
| At least one of the following: (1) acquired abnormality in motor function or (2) decline in motivation, emotional control, or social behavior. | |
| Memorial Sloan Kettering (MSK) Staging (1988)17 | |
| ADC 0.5 | Equivocal/subclinical cognitive impairment |
| Absent, minimal, or equivocal symptoms without impairment of work or capacity to perform ADLs. Gait and strength are normal | |
| ADC 1 | Mild dementia |
| Able to perform all but the more demanding aspects of work or ADL but with unequivocal evidence of functional intellectual or motor impairment. Can walk without assistance | |
| ADC 2 | Moderate dementia |
| Able to perform basic activities of self-care but cannot work or maintain the more demanding aspects of daily life. Ambulatory, but may require a single prop. | |
| ADC 3 | Severe dementia |
| Major intellectual incapacity (cannot follow news or personal events, sustain complex conversation, etc.) or motor disability (cannot walk unassisted, usually with slowing, and clumsiness of arms as well). | |
| ADC 4 | End stage dementia |
| Nearly vegetative. Intellectual and social comprehension and output are rudimentary. Nearly or absolutely mute. Paraparetic or paraplegic with urinary and fecal incontinence. | |
1
Impairments must not be explained by comorbid conditions (such as central nervous system [CNS] opportunistic infections, drug or alcohol abuse, or prior brain injury), and individual may not meet criteria for delirium or dementia.