title: The Montreal Cognitive Assessment: A Pilot Study of a Brief Screening Tool for Mild and Moderate Cognitive Impairment in HIV-Positive Veterans.
abstract: HIV-associated neurocognitive disorders (HANDs) are common, often go undetected, and can impact treatment outcomes. There is limited evidence on how to perform routine cognitive screening in HIV clinical settings. To address this, 44 HIV-positive males were recruited from a Veteran Affairs Infectious Disease clinic and completed the Montreal Cognitive Assessment (MoCA), International HIV Dementia Scale (IHDS), and Depression Anxiety and Stress Scale-21. In all, 50% scored below the MoCA cutoff and 36% scored below the IHDS cutoff. Current CD4 was the strongest predictor of an abnormal MoCA score (P = .007, 95% confidence interval [CI]: 0.987-0.998) and elevated depression was the second strongest predictor (P = .008, CI: 1.043-1.326). Combination antiviral therapy use and age were not significant predictors in this model. The MoCA appeared to be a reasonable screening tool to detect cognitive impairment in HIV-positive patients, and although it is not sufficient to diagnose HAND, it has the potential to provide meaningful clinical data.
authors.affiliation: Department of Veterans Affairs Medical Center, San Francisco VA Medical Center, San Francisco, CA, USA Department of Psychiatry, University of California San Francisco, San Francisco, CA, USA maggie.chartier@va.gov.
authors.forename: Maggie
authors.initials: M
authors.lastname: Chartier
authors.affiliation: Department of Veterans Affairs Medical Center, San Francisco VA Medical Center, San Francisco, CA, USA Department of Community Health Systems, School of Nursing, University of California San Francisco, San Francisco, CA, USA.
authors.forename: Pierre-Cédric
authors.initials: PC
authors.lastname: Crouch
authors.affiliation: Tucson, AZ, USA.
authors.forename: Van
authors.initials: V
authors.lastname: Tullis
authors.affiliation: Department of Neurology, University of California San Francisco, Memory and Aging Center, San Francisco, CA, USA.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Catella
authors.affiliation: Seneca Center Family of Agencies, San Francisco, CA, USA.
authors.forename: Erin
authors.initials: E
authors.lastname: Frawley
authors.affiliation: Department of Veterans Affairs Medical Center, San Francisco VA Medical Center, San Francisco, CA, USA Department of Psychiatry, University of California San Francisco, San Francisco, CA, USA.
authors.forename: Charles
authors.initials: C
authors.lastname: Filanosky
authors.affiliation: Department of Veterans Affairs Medical Center, San Francisco VA Medical Center, San Francisco, CA, USA Department of Psychiatry, University of California San Francisco, San Francisco, CA, USA.
authors.forename: Timothy
authors.initials: T
authors.lastname: Carmody
authors.affiliation: Department of Veterans Affairs Medical Center, San Francisco VA Medical Center, San Francisco, CA, USA Department of Psychiatry, University of California San Francisco, San Francisco, CA, USA.
authors.forename: John
authors.initials: J
authors.lastname: McQuaid
authors.affiliation: Department of Veterans Affairs Medical Center, San Francisco VA Medical Center, San Francisco, CA, USA Department of Medicine, University of California San Francisco, San Francisco, CA, USA.
authors.forename: Harry
authors.initials: H
authors.lastname: Lampiris
authors.affiliation: Department of Veterans Affairs Medical Center, San Francisco VA Medical Center, San Francisco, CA, USA Department of Medicine, University of California San Francisco, San Francisco, CA, USA.
authors.forename: Joseph K
authors.initials: JK
authors.lastname: Wong
mesh_terms: D000328:Adult; D000368:Aged; D003071:Cognition; D003072:Cognition Disorders / Q000175:diagnosis* / Q000209:etiology / Q000523:psychology* / Q000821:virology; D015658:HIV Infections / Q000150:complications*; D015497:HIV-1 / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D010865:Pilot Projects; D014728:Veterans / Q000706:statistics & numerical data; D019562:Viral Load
keywords: HAND; HIV/AIDS; cognitive impairment; depression; veterans