Screening for HIV-Associated Neurocognitive Impairment: Relevance of Psychological Factors and Era of Commencement of Antiretroviral Therapy.
Susan Herrmann, Elizabeth McKinnon, Matthew Skinner and 4 others
PMID 30586348WHAT IT FOUND
In people living with HIV, the MoCA cognitive screen flagged possible impairment far more often than self-reported cognitive concerns.
MoCA results were linked to when patients first started HIV treatment, while self-reported concerns tracked mood.
Key findings
01The MoCA and the three-item cognitive concerns questionnaire agreed poorly as indicators of neurocognitive impairment.
02Self-reported cognitive concerns were linked to higher depression and anxiety scores, while baseline MoCA indication of impairment was not.
03Patients who started antiretroviral therapy in the early treatment era were more likely to have below-threshold MoCA scores, independently of age.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study used a convenience sample of 58 people from one clinic, and not all participants contributed longitudinal data. There was no HIV-negative control group, so the findings do not show that HIV alone caused the screen results. The 16-month study period was too short to assess stability or decline over time. The small sample may have lacked power to detect associations with immune measures or other conditions. Information on family history of dementia and other risk markers was lacking.
Declared interests
The authors reported no real or perceived vested interests related to this article.
The easy way to misread this
Do not read below-threshold MoCA scores as confirmed HIV-related neurocognitive impairment. The MoCA was used as a screen, the study had no HIV-negative control group, and the authors noted impairment could not be attributed to HIV alone.