title: Diagnostic utility of the HIV dementia scale and the international HIV dementia scale in screening for HIV-associated neurocognitive disorders among Spanish-speaking adults.
abstract: Given that neurocognitive impairment is a frequent complication of HIV-1 infection in Spanish-speaking adults, the limited number of studies assessing HIV-associated neurocognitive disorders (HAND) in this population raises serious clinical concern. In addition to being appropriately translated, instruments need to be modified, normed, and validated accordingly. The purpose of the current study was to examine the diagnostic utility of the HIV Dementia Scale (HDS) and International HIV Dementia Scale (IHDS) to screen for HAND in Spanish-speaking adults living with HIV infection. Participants were classified as either HAND (N = 47) or No-HAND (N = 53) after completing a comprehensive neuropsychological evaluation. Receiver operating characteristic analyses found the HDS (AUC = .706) was more sensitive to detecting HAND than the IHDS (AUC = .600). Optimal cutoff scores were 9.5 for the HDS (PPV = 65.2%, NPV = 71.4%) and 9.0 for the IHDS (PPV = 59.4%, NPV = 59.1%). Canonical Correlation Analysis found the HDS converged with attention and executive functioning. Findings suggest that while the IHDS may not be an appropriate screening instrument with this population, the HDS retains sufficient statistical validity and clinical utility to screen for HAND in Spanish-speaking adults as a time-efficient and cost-effective measure in clinical settings with limited resources.
authors.affiliation: a Department of Psychiatry and Behavioral Neurosciences , Cedars-Sinai Medical Center , Los Angeles , California , USA.|b Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine , University of California Los Angeles , Los Angeles , California , USA.
authors.forename: Enrique
authors.initials: E
authors.lastname: López
authors.affiliation: a Department of Psychiatry and Behavioral Neurosciences , Cedars-Sinai Medical Center , Los Angeles , California , USA.|c Department of Psychology, California School of Professional Psychology , Alliant International University , Alhambra , California , USA.
authors.forename: Alexander J
authors.initials: AJ
authors.lastname: Steiner
authors.affiliation: a Department of Psychiatry and Behavioral Neurosciences , Cedars-Sinai Medical Center , Los Angeles , California , USA.
authors.forename: Kimberly
authors.initials: K
authors.lastname: Smith
authors.affiliation: b Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine , University of California Los Angeles , Los Angeles , California , USA.
authors.forename: Nicholas S
authors.initials: NS
authors.lastname: Thaler
authors.affiliation: b Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine , University of California Los Angeles , Los Angeles , California , USA.|d Department of Psychology , Loyola Marymount University , Los Angeles , California , USA.
authors.forename: David J
authors.initials: DJ
authors.lastname: Hardy
authors.affiliation: e Department of Neurology, David Geffen School of Medicine , University of California Los Angeles (UCLA) , Los Angeles , California , USA.
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Levine
authors.affiliation: b Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine , University of California Los Angeles , Los Angeles , California , USA.|f Graduate School of Education and Psychology , Pepperdine University , Los Angeles , California , USA.
authors.forename: Hussah T
authors.initials: HT
authors.lastname: Al-Kharafi
authors.affiliation: b Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine , University of California Los Angeles , Los Angeles , California , USA.
authors.forename: Cristina
authors.initials: C
authors.lastname: Yamakawa
authors.affiliation: g Department of Psychiatry and Behavioral Sciences, Quillen College of Medicine , East Tennessee State University , Johnson City , Tennessee , USA.
authors.forename: Karl
authors.initials: K
authors.lastname: Goodkin
mesh_terms: D015526:AIDS Dementia Complex / Q000175:diagnosis; D000328:Adult; D005260:Female; D015658:HIV Infections / Q000150:complications*; D006630:Hispanic or Latino; D006801:Humans; D015141:Los Angeles; D008297:Male; D008875:Middle Aged; D019965:Neurocognitive Disorders / Q000175:diagnosis* / Q000209:etiology*; D009483:Neuropsychological Tests / Q000592:standards*
keywords: AIDS; Latino/a; Spanish; cognitive disorders; dementia; infectious disease; neuropsychology