title: Concordance Between Self-Report and Performance-Based Measures of Everyday Functioning in HIV-Associated Neurocognitive Disorders.
abstract: Self-report is typically used to differentiate between asymptomatic neurocognitive impairment (ANI) and mild neurocognitive disorder (MND) in the assessment of HIV-associated neurocognitive disorders (HAND). Yet, it is unclear whether the lack of self-reported functional impairments in individuals with ANI is indicative of a genuine absence of functional impairment, or of inaccurate self-reports. In the present study, we examined the relationship between previously validated self-report (patient's assessment of own functioning inventory; instrumental activities of daily living inventory) and performance-based (the Texas Functional Living Scale) measures of functional abilities in 112 virologically-controlled HIV-infected, and 40 well-matched, HIV-uninfected participants. Participants with symptomatic cognitive impairment (CI) had significantly lower overall scores and higher rates of impairment on a performance-based measure of everyday functioning as compared to participants with either asymptomatic CI or normal cognitive performance (WNL [within normal limits]; all p < 0.05), while asymptomatic CI and WNL participants had comparable rates of impairment and performance within the average range on the performance-based measure. The concordance between self-report and performance-based measures of everyday functioning in asymptomatic and symptomatic CI provide support for ANI and MND as clinically distinct diagnostic entities, and support the use of self-reports as appropriate measures of everyday functioning in the diagnosis of HAND.
authors.affiliation: Office of the Clinical Director, National Institute of Mental Health, National Institutes of Health, 10 Center Drive room 3n218, Bethesda, MD, 20814, USA. talia.shirazi@gmail.com.
authors.forename: Talia N
authors.identifier: http://orcid.org/0000-0002-6503-9614
authors.initials: TN
authors.lastname: Shirazi
authors.affiliation: Office of the Clinical Director, National Institute of Mental Health, National Institutes of Health, 10 Center Drive room 3n218, Bethesda, MD, 20814, USA.
authors.forename: Angela C
authors.initials: AC
authors.lastname: Summers
authors.affiliation: Section of Infections of the Nervous System, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA.
authors.forename: Bryan R
authors.initials: BR
authors.lastname: Smith
authors.affiliation: Section of Infections of the Nervous System, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA.|Clinical Research Directorate/Clinical Monitoring Research Program, Frederick National Laboratory for Cancer Research, Leidos Biomedical Research Inc., Frederick, MD, 21702, USA.
authors.forename: Sally R
authors.initials: SR
authors.lastname: Steinbach
authors.affiliation: Office of the Clinical Director, National Institute of Mental Health, National Institutes of Health, 10 Center Drive room 3n218, Bethesda, MD, 20814, USA.|Department of Psychiatry and the Behavioral Sciences, University of Southern California Keck School of Medicine, Los Angeles, CA, USA.
authors.forename: Suad
authors.initials: S
authors.lastname: Kapetanovic
authors.affiliation: Section of Infections of the Nervous System, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA.
authors.forename: Avindra
authors.initials: A
authors.lastname: Nath
authors.affiliation: Office of the Clinical Director, National Institute of Mental Health, National Institutes of Health, 10 Center Drive room 3n218, Bethesda, MD, 20814, USA.
authors.forename: Joseph
authors.initials: J
authors.lastname: Snow
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D016022:Case-Control Studies; D003071:Cognition; D003072:Cognition Disorders / Q000209:etiology / Q000523:psychology*; D060825:Cognitive Dysfunction / Q000209:etiology / Q000523:psychology*; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D057566:Self Report
keywords: Everyday functioning; HIV-associated neurocognitive disorders; Instrumental activities of daily living; Self-reports; Texas Functional Living Scale