title: Correlations between computerized battery testing and a memory questionnaire for identification of neurocognitive impairment in HIV type 1-infected subjects on stable antiretroviral therapy.
abstract: Neurocognitive impairment (NCI) remains prevalent in the highly active antiretroviral therapy (HAART) era. Memory function is commonly affected. There is a need for a rapid, but sensitive screening tool. This study compares the Prospective and Retrospective Memory Questionnaire (PRMQ) and a computerised battery cognitive assessment to establish if the questionnaire has potential as a rapid screening tool for HIV-associated NCI. Neurologically asymptomatic patients with an undetectable HIV viral load on stable HAART were eligible to participate. Asymptomatic NCI (aNCI) was defined as a performance score more than 1SD below the normative mean in at least two domains of the computerised test. Memory impairment (MI) was defined as a t-score more than 1 SD below the normative mean using the PRMQ. Forty-five subjects participated. The mean age was 48 years (SD 11), the mean CD4 count was 546 cells/mul (SD 271), and 84% were male. Of subjects, 14/45 (24%) had NCI and 15/45 (33%) had MI. Two subjects had both types of impairment. No significant association was found between the presence of aNCI and MI (p = 0.229, r = 0.18, 95% CI -1.2, 0.23). aNCI was statistically significantly associated with younger age (p = 0.38, r = 0.31, 95% CI -0.02, 0.001). MI was statistically significantly associated with the set-shifting cognitive domain of the computerized battery (p = 0.04, r = 0.326) and time elapsed since HIV diagnosis (p = 0.035, r = 0.316). High rates of asymptomatic NCI were observed in this cohort, especially in younger individuals. The memory questionnaire did not reliably identify HIV-associated NCI other than executive function deficits and based on our data should therefore not be used as a rapid screening tool for this purpose.
authors.affiliation: Department of HIV Medicine, Imperial College Healthcare NHS Trust, London, UK. L.garvey@imperial.ac.uk
authors.forename: Lucy J
authors.initials: LJ
authors.lastname: Garvey
authors.forename: Dharani
authors.initials: D
authors.lastname: Yerrakalva
authors.forename: Alan
authors.initials: A
authors.lastname: Winston
mesh_terms: D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D003072:Cognition Disorders / Q000175:diagnosis* / Q000209:etiology; D003201:Computers; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy / Q000523:psychology; D015497:HIV-1 / Q000187:drug effects*; D006801:Humans; D008297:Male; D008568:Memory / Q000187:drug effects; D008875:Middle Aged; D009483:Neuropsychological Tests; D011795:Surveys and Questionnaires; D019562:Viral Load