Comparison of the Minimental State Examination Scale and the International HIV Dementia Scale in Assessing Cognitive Function in Nigerian HIV Patients on Antiretroviral Therapy.

O. Olajumoke Oshinaike,A. Akinsegun Akinbami,O. Oluwadamilola Ojo,A. Mustapha Danesi,U. Njideka Okubadejo,I. Frank Ojini

doi:10.1155/2012/581531

O. Olajumoke Oshinaike, A. Akinsegun Akinbami + Show 4 more

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https://doi.org/10.1155/2012/581531

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Abstract

Introduction. HIV-associated neurocognitive disorder (HAND) remains common despite the availability of antiretroviral therapy. Routine screening will improve early detections. Objective. To compare the performance of the minimental state examination (MMSE) and international HIV dementia scale (IHDS) in assessing neurocognitive function in HIV/AIDS patients on antiretroviral therapy. Methods. A case-control study of 208 HIV-positive and 121 HIV-negative individuals. Baseline demographic data were documented and cognitive function assessed using the two instruments. CD4 cell counts were recorded. Results. Cases comprised 137 females and 71 males. Controls were 86 females and 35 males. Mean MMSE score of cases was 27.7 ± 1.8 compared to 27.8 ± 1.3 in controls (P = 0.54). Mean IHDS score in cases was 8.36 ± 3.1 compared to 10.7 ± 0.9 in controls (P < 0.001). Using the MMSE scale, 6 cases but no controls had HAND (P = 0.09). Using the IHDS, 113 (54.3%) had HAND compared with 10 (8.3%) controls (P < 0.0001). Using IHDS, 56.5% cases with CD4 count > 200 had HAND compared with 92.5% with CD4 count < 200 (P < 0.001). Conclusion. These findings indicate that the IHDS detects higher rates of HAND and may identify HIV/AIDS patients who require further cognitive assessment using more robust assessment batteries.

Highlights

HIV-associated neurocognitive disorder (HAND) remains common despite the availability of antiretroviral therapy
minor neurocognitive disorder (MND) is associated with shortened survival, reduced adherence with antiretroviral therapy, and problems with employability, and its presence is predictive of HIV-associated dementia (HAD)
Using the international HIV dementia scale (IHDS) scale, based on a cutoff score of 10 (

Summary

Introduction

HIV-associated neurocognitive disorder (HAND) remains common despite the availability of antiretroviral therapy. To compare the performance of the minimental state examination (MMSE) and international HIV dementia scale (IHDS) in assessing neurocognitive function in HIV/AIDS patients on antiretroviral therapy. Mean IHDS score in cases was 8.36 ± 3.1 compared to 10.7 ± 0.9 in controls (P < 0.001). These findings indicate that the IHDS detects higher rates of HAND and may identify HIV/AIDS patients who require further cognitive assessment using more robust assessment batteries. The spectrum ranges from mild and asymptomatic neurocognitive impairment (ANI), minor neurocognitive disorder (MND), to the more severe HIV-associated dementia (HAD) [1]. HAD represents the most severe form of cognitive dysfunction, with significant functional impairments, and is synonymous with HIV encephalopathy and AIDS dementia complex (ADC). ADC is one of the most common central nervous system complications of late HIV infection occurring in 15–20% of patients before the introduction of HAART [2, 3]

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