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Journal of NeuroVirology

, Volume 17, Issue 2, pp 159–165 | Cite as

A comparison of performance-based measures of function in HIV-associated neurocognitive disorders

  • Nishiena S. Gandhi
  • Richard L. Skolasky
  • Katherine B. Peters
  • Richard T. MoxleyIV
  • Jason Creighton
  • Heidi Vornbrock Roosa
  • Ola A. Selnes
  • Justin McArthur
  • Ned SacktorEmail author
Article

Abstract

The objectives of this study are to compare the results of newer performance-based functional assessments in the study of HIV-associated neurocognitive disorders (HAND) and to correlate these functional assessments with specific levels of severity of HAND. One hundred fourteen HIV+ subjects in an existing cohort were evaluated with a medical history, neurological exam, neuropsychological test battery as well as subjective and novel objective measures of functional abilities. Self-reported measures of functional performance included the Karnofsky Performance Scale, a questionnaire for instrumental activities of daily living, and a questionnaire for physical quality of life measures. The newer objective functional performance assessments included the Columbia Medication Management and the San Diego Finances tests. These newer performance-based measures of function were assessed for their ability to predict level of HAND. The two objective measures of functional performance, The Columbia Medication Management Scale and the San Diego Finances Test, were both associated with levels of severity of HAND. The Karnofsky Performance Scale and the questionnaires for role and physical quality of life were subjective measures that were also associated with specific levels of HAND. Newer measures of functional performance can be used to objectively evaluate functional impairment in HAND and validate different levels of HAND.

Keywords

HIV HIV-associated neurocognitive disorders Functional outcome measures 

Notes

Disclosure

The authors report no conflicts of interest.

References

  1. Antinori A, Arendt G, Becker JT, Brew BJ, Byrd DA, Cherner M, Clifford DB, Cinque P, Epstein LG, Goodkin K, Gisslen M, Grant I, Heaton RK, Joseph J, Marder K, Marra CM, McArthur JC, Nunn M, Price RW, Pulliam L, Robertson KR, Sacktor N, Valcour V, Wojna VE (2007) Updated research nosology for HIV-associated neurocognitive disorders. Neurology 69:1789–1799PubMedCrossRefGoogle Scholar
  2. Benedict RH, Mezhir JJ, Walsh K, Hewitt RG (2000) Impact of human immunodeficiency virus type-1-associated cognitive dysfunction on activities of daily living and quality of life. Arch Clin Neuropsychol 15:535–544PubMedGoogle Scholar
  3. Fahn S, Marsden C, Caine D (1987) Recent developments in Parkinson’s disease. Macmillan Healthcare Information, Florham ParkGoogle Scholar
  4. Fogarty L, Roter D, Larson S, Burke J, Gillespie J, Levy R (2002) Patient adherence to HIV medication regimens: a review of published and abstract reports. Patient Educ Couns 46:93–108PubMedCrossRefGoogle Scholar
  5. Fuh JL, Wang SJ (2006) Assessing quality of life in Taiwanese patients with Alzheimer’s disease. Int J Geriatr Psychiatry 21:103–107PubMedCrossRefGoogle Scholar
  6. Gandhi NS, Moxley CJ, Vornbrock Roosa H, Skolasky RL, Selnes OA, McArthur J, Sacktor N (2010) Comparison of scales to evaluate the progression of HIV-associated neurocognitive disorder. HIV Therapy 4:373–379CrossRefGoogle Scholar
  7. Graham DP, Kunik ME, Doody R, Snow AL (2005) Self-reported awareness of performance in dementia. Brain Res Cogn Brain Res 25:144–152PubMedCrossRefGoogle Scholar
  8. Gross R (2007) Predicting and monitoring antiretroviral adherence. LDI Issue Brief 13:1–4PubMedGoogle Scholar
  9. Heaton RK, Marcotte TD, Mindt MR, Sadek J, Moore DJ, Bentley H, McCutchan JA, Reicks C, Grant I (2004) The impact of HIV-associated neuropsychological impairment on everyday functioning. J Int Neuropsychol Soc 10:317–331PubMedCrossRefGoogle Scholar
  10. Hinkin CH, Castellon SA, Durvasula RS, Hardy DJ, Lam MN, Mason KI, Thrasher D, Goetz MB, Stefaniak M (2002) Medication adherence among HIV+ adults: effects of cognitive dysfunction and regimen complexity. Neurology 59:1944–1950PubMedGoogle Scholar
  11. Karnofsky D, Abelman W, Craver L, Burchenal J (1948) The use of nitrogen mustards in the palliative treatment of carcinoma. Cancer 1:634–656CrossRefGoogle Scholar
  12. Lawton MP, Brody EM (1969) Assessment of older people: self-maintaining and instrumental activities of daily living. Gerontologist 9:179–186PubMedGoogle Scholar
  13. McArthur JC, McDermott M, McClernon D, St Hillaire C, Conant K, Marder K, Schifitto G, Selnes OA, Sacktor N, Stern Y, Albert S, Palumbo D, Kieburtz K, De Marcaida JA, Cohen B, Epstein LG (2004) Attenuated CNS infection in advanced HIV/AIDS with highly active antireteroviral therapy. Arch Neurol 61:1687–1696PubMedCrossRefGoogle Scholar
  14. Mohamed MA, Barker PB, Skolasky RL, Moxley RT, Pomper MG, Sacktor NC (2010) Brain metabolism and cognitive impairment in HIV infection: a 3-T magnetic resonance spectroscopy study. Magn Reson Imaging 28(9):1251–1257PubMedCrossRefGoogle Scholar
  15. Munakata J, Benner JS, Becker S, Dezii CM, Hazard EH, Tierce JC (2006) Clinical and economic outcomes of nonadherence to highly active antiretroviral therapy in patients with human immunodeficiency virus. Med Care 44:893–899PubMedCrossRefGoogle Scholar
  16. Ready RE, Ott BR (2007) Integrating patient and informant reports on the cornell-brown quality-of-life scale. Am J Alzheimers Dis Other Demen 22:528–534PubMedCrossRefGoogle Scholar
  17. Ready RE, Ott BR, Grace J (2004a) Validity of informant reports about AD and MCI patients’ memory. Alzheimer Dis Assoc Disord 18:11–16PubMedCrossRefGoogle Scholar
  18. Ready RE, Ott BR, Grace J (2004b) Patient versus informant perspectives of quality of life in mild cognitive impairment and alzheimer’s disease. Int J Geriatr Psychiatry 19:256–265PubMedCrossRefGoogle Scholar
  19. Sacktor N (2002) The epidemiology of human immunodeficiency virus-associated neurological disease in the era of highly active antiretroviral therapy. J Neurovirol 8(Suppl 2):115–121PubMedCrossRefGoogle Scholar
  20. Sacktor N, McDermott MP, Marder K, Schifitto G, Selnes OA, McArthur JC, Stern Y, Albert S, Palumbo D, Kieburtz K, De Marcaida JA, Cohen B, Epstein L (2002) HIV-associated cognitive impairment before and after the advent of combination therapy. J Neurovirol 8:136–142PubMedCrossRefGoogle Scholar
  21. Saxton J, Morrow LA, Baumann S, Zuccolotto A, Schneider W, Offerman J, Dekosky ST (2005) The computer-based assessment of mild cognitive impairment (CAMCI). Thirty-Third Annual International Neuropsychological Society Conference 33Google Scholar
  22. Schifitto G, Kieburtz K, McDermott MP, McArthur J, Marder K, Sacktor N, Palumbo D, Selnes O, Stern Y, Epstein L, Albert S (2001) Clinical trials in HIV-associated cognitive impairment: cognitive and functional outcomes. Neurology 56:415–418PubMedGoogle Scholar
  23. Snow AL, Graham DP, Molinari VA, Orengo CA, Doody RS, Norris MP, Kunik ME (2005) Factors affecting deficit awareness in persons with dementia. Dement Geriatr Cogn Disord 20:133–139PubMedCrossRefGoogle Scholar
  24. Van Gorp WG, Baerwald JP, Ferrando SJ, McElhiney MC, Rabkin JG (1999) The relationship between employment and neuropsychological impairment in HIV infection. J Int Neuropsychol Soc 5:534–539PubMedGoogle Scholar
  25. Vogel A, Mortensen EL, Hasselbalch SG, Andersen BB, Waldemar G (2006) Patient versus informant reported quality of life in the earliest phases of Alzheimer’s disease. Int J Geriatr Psychiatry 21:1132–1138PubMedCrossRefGoogle Scholar

Copyright information

© Journal of NeuroVirology, Inc. 2011

Authors and Affiliations

  • Nishiena S. Gandhi
    • 1
  • Richard L. Skolasky
    • 2
  • Katherine B. Peters
    • 3
  • Richard T. MoxleyIV
    • 1
  • Jason Creighton
    • 1
  • Heidi Vornbrock Roosa
    • 1
  • Ola A. Selnes
    • 1
  • Justin McArthur
    • 1
  • Ned Sacktor
    • 1
    • 4
    Email author
  1. 1.Department of NeurologyJohns Hopkins University School of MedicineBaltimoreUSA
  2. 2.Department of Orthopedic SurgeryJohns Hopkins University School of MedicineBaltimoreUSA
  3. 3.Department of NeurologyDuke UniversityDurhamUSA
  4. 4.Department of NeurologyJohns Hopkins Bayview Medical CenterBaltimoreUSA

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