Abstract
We aimed to examine the l differences in the assessment of neurocognitive impairment (NCI) using cognitive screening tools between PLWH and HIV-negative individuals and further compare the neurocognitive profiles between the two groups. This was baseline evaluation of Pudong HIV Aging Cohort, including 465 people living with HIV (PLWH) and 465 HIV-negative individuals aged over 50 years matched by age (± 3 years), sex and education. NCI was assessed using the Chinese version of Mini-mental State Examination (MMSE), the International HIV Dementia Scale (IHDS) and Beijing version of Montreal Cognitive Assessment (MoCA). In total, 258 (55.5%), 91 (19.6%), 273 (58.7%) of PLWH were classified as having NCI by the IHDS, MMSE and MoCA, compared to 90 (19.4%), 25 (5.4%), 135 (29.0%) of HIV-negative individuals, respectively (p < 0.05); such associations remained significant in multivariable analysis. PLWH showed a larger overlap of NCI detected by IHDS, MMSE, and MoCA. IHDS and MoCA detected almost all of the NCI detected by MMSE. IHDS-motor and psychomotor speeds and MoCA-executive function showed the greatest disparities between two groups. In multivariable analysis, older age and more depressive symptoms were positively associated with NCI regardless of the screening tools or HIV serostatus. PLWH over 50 years old display a higher prevalence of NCI and distinct neurocognitive profiles compared to HIV-negative individuals, despite viral suppression. Given the more considerable overlap in NCI classification in PLWH, it is advisable to choose one screening tool such as IHDS or MoCA to identify those potentially having NCI and then refer to more comprehensive neuropsychological assessment.
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P. C, Y. D. and N. H. contributed to the conception or design of the work. P. C., X. X., S. X. contributed to supervising subject enrollment and data collection. P. C. and X. X. contributed to data analysis and manuscript draft. H. L., X. L. contributed to the data collection. Y. D. critically revised the manuscript. All authors critically reviewed and edited the manuscript and consented to final publication.
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This work was supported by Research Grant for Health Science and Technology of Pudong New Area Health Commission of Shanghai (PW2020A-10), Pudong New Area Science and Technology Development Innovation fund (PKJ2023-Y71), Academic Leaders Training Program of Pudong Health Commission of Shanghai (PWRd2022-01), Medical discipline Construction Project of Pudong Health Committee of Shanghai (PWYgts2021-04), National Natural Science Foundation of China (82173579), and Shanghai three-year (2023–2025) action plan to strengthen the public health system (GWVI-11.1-05).
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Chen, P., Xin, X., Xiao, S. et al. Cognitive impairment and neurocognitive profiles among people living with HIV and HIV-negative individuals older over 50 years: a comparison of IHDS, MMSE and MoCA. J. Neurovirol. (2024). https://doi.org/10.1007/s13365-024-01205-y
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DOI: https://doi.org/10.1007/s13365-024-01205-y