title: Operationalization of the updated diagnostic algorithm for classifying HIV-related cognitive impairment and dementia.
abstract: BACKGROUND
  This study applies the updated HIV-Associated Neurocognitive Disorders (HAND) diagnostic algorithm.
  
  
  METHODS
  Participants were 210 HIV-infected-adults, classified using proposed HAND criteria: HIV-Associated Dementia (HAD), Mild Neurocognitive Disorder (MND), Asymptomatic Neurocognitive Impairment (ANI).
  
  
  RESULTS
  The algorithm yielded: normal = 32.8%, ANI = 21.4%, MND = 34.3%, and HAD = 11.4%. Normal participants performed superior to HAND-defined participants on cognition, and HAD participants performed more poorly on global cognition and executive functioning. Two distinct subgroups of interest emerged: (1) functional decline without cognitive impairment; (2) severe cognitive impairment and minimal functional compromise.
  
  
  CONCLUSIONS
  The algorithm discriminates between HIV-infected cognitively impaired individuals. Diagnosis yields two unique profiles requiring further investigation. Findings largely support the algorithm's utility for diagnosing HIV-cognitive-impairment, but suggest distinct subsets of individuals with discrepant cognitive/functional performances that may not be readily apparent by conventional application of HAND diagnosis.
authors.affiliation: UCLA Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry and Biobehavioral Sciences, Los Angeles, California, U.S.A.
authors.forename: J M
authors.initials: JM
authors.lastname: Foley
authors.forename: M J
authors.initials: MJ
authors.lastname: Wright
authors.forename: A L
authors.initials: AL
authors.lastname: Gooding
authors.forename: M
authors.initials: M
authors.lastname: Ettenhofer
authors.forename: M
authors.initials: M
authors.lastname: Kim
authors.forename: M
authors.initials: M
authors.lastname: Choi
authors.forename: S A
authors.initials: SA
authors.lastname: Castellon
authors.forename: J
authors.initials: J
authors.lastname: Sadek
authors.forename: R K
authors.initials: RK
authors.lastname: Heaton
authors.forename: W G
authors.initials: WG
authors.lastname: van Gorp
authors.forename: T D
authors.initials: TD
authors.lastname: Marcotte
authors.forename: C H
authors.initials: CH
authors.lastname: Hinkin
mesh_terms: D015526:AIDS Dementia Complex / Q000150:complications / Q000175:diagnosis / Q000523:psychology; D000328:Adult; D000465:Algorithms; D003072:Cognition Disorders / Q000145:classification / Q000175:diagnosis / Q000209:etiology; D039721:Diagnostic and Statistical Manual of Mental Disorders; D056344:Executive Function; D005260:Female; D006801:Humans; D007361:Intelligence Tests; D008297:Male; D016743:Mental Competency; D011939:Mental Recall; D008875:Middle Aged; D009483:Neuropsychological Tests; D011569:Psychiatric Status Rating Scales; D011597:Psychomotor Performance