Abstract

Mini-Mental State Examination (MMSE) lacks of sensitivity in detecting cognitive deficits associated with subcortical damage. The HIV-Dementia Scale (HDS), a screening tool originally created for detecting cognitive impairment due to subcortical damage in HIV + patients, has proved to be useful in other neurological diseases. Until now, an Italian version of the HDS is not available. We aimed at: (1) validating the HDS Italian version (HDS-IT) in a cohort of cognitively healthy subjects (CN); (2) exploring the suitability of HDS-IT in detecting cognitive impairment due to subcortical damage (scCI). The psychometric properties of the HDS-IT were assessed in 180 CN (mean age 67.6 ± 8.3, range 41–84) with regard to item-total correlation, test–retest reliability and convergent validity with MMSE. Item-total correlations ranged 0.44–0.72. Test–retest reliability was 0.70 (p < 0.001). The HDS-IT scores were positively associated with MMSE score (rS = 0.49, p < 0.001). Then, both the HDS-IT and the MMSE were administered to 44 scCI subjects (mean age 64.9 ± 10.6, range 41–84). Mean HDS-IT total score was close to the original version and significantly lower in the scCI group compared to CN (8.6 ± 3.6 vs. 12.6 ± 2.5, p < 0.001). ROC analysis yielded an optimal cutoff value of 11, with sensitivity of 0.70 and specificity of 0.82. Patients showed poorer scores on HDS-IT compared to CN (12.6 ± 2.5 vs. 8.6 ± 3.6, p < 0.001). Our results support the use of HDS-IT as a screening tool suitable for detecting cognitive deficits with prevalent subcortical pattern, being complementary to MMSE in clinical practice.

Highlights

  • Detection of cognitive impairment in the ageing population represents an important issue

  • The purposes of this study were to validate the Italian version of the HIV-Dementia Scale (HDS) (HDS-IT) in a cohort of cognitively healthy elderly subjects and to explore its suitability as a sensitive screening tool for detecting subcortical cognitive impairment in subjects with neurological diseases associated with subcortical damage

  • We found a trend in convergent validity between HDS and Mini-Mental State Examination (MMSE)

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Summary

Introduction

Detection of cognitive impairment in the ageing population represents an important issue. It is known that mild cognitive impairment (MCI) in adult patients is a frequent and heterogeneous condition that may be related to different underlying causes, especially neurodegenerative or cerebrovascular diseases [1, 2]. Neurological disorders affecting the central nervous system are associated with a wide spectrum of clinical manifestations, often accompanied by presence of such cognitive dysfunctions, and in some cases, dementia.

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