Journal of NeuroVirology

, Volume 19, Issue 1, pp 109–116 | Cite as

The Alzheimer’s disease-8 and Montreal Cognitive Assessment as screening tools for neurocognitive impairment in HIV-infected persons

  • Edgar Turner Overton
  • Tej D. Azad
  • Neva Parker
  • Debra Demarco Shaw
  • Judy Frain
  • Teresa Spitz
  • Elizabeth Westerhaus
  • Robert Paul
  • David B. Clifford
  • Beau M. Ances


The diagnosis of human immunodeficiency virus (HIV)-associated neurocognitive impairment is time-intensive and often omitted in busy outpatient settings. Brief screening tools are needed. The Montreal Cognitive Assessment (MoCA) and the Alzheimer’s disease (AD)-8 have been used in neurodegenerative disorders. We evaluated the sensitivity and specificity of these brief screening tools in HIV-infected persons. The AD-8, MoCA, and formal neuropsychological testing were administered to 200 HIV-infected patients who were followed at a single institution. Normalized scores on formal neuropsychological testing were used to define neurocognitive impairment. The sensitivity and specificity of the MoCA and AD-8 were assessed to diagnose the impairment. Neurocognitive impairment was highly prevalent in this cohort: 127 persons (64 %) were diagnosed with neurocognitive impairment based on formal testing. Using the AD-8 and MoCA, 113 (57 %) and 101 (51 %) persons were identified with neurocognitive impairment, respectively. The sensitivity and specificity of MoCA were 63 % and 71 %, respectively. The sensitivity and specificity of AD-8 were 61 % and 51 %, respectively. Our findings highlight that brief screening tools correlate with formal neuropsychological testing. However, the sensitivities of these screening tools are lower than desired. Nevertheless, given their ease in administration, these tools could assist as a first line for identifying individuals who may subsequently require formal neuropsychological testing.


HIV Neurocognitive disorder MoCA AD-8 Neuropsychological testing Cognition 


Conflict of interest

No authors report conflict of interest.


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Copyright information

© Journal of NeuroVirology, Inc. 2012

Authors and Affiliations

  • Edgar Turner Overton
    • 1
  • Tej D. Azad
    • 2
  • Neva Parker
    • 2
  • Debra Demarco Shaw
    • 3
  • Judy Frain
    • 3
  • Teresa Spitz
    • 3
  • Elizabeth Westerhaus
    • 2
  • Robert Paul
    • 4
  • David B. Clifford
    • 2
  • Beau M. Ances
    • 2
    • 5
  1. 1.Department of MedicineUniversity of Alabama BirminghamBirminghamUSA
  2. 2.Department of NeurologyWashington University in Saint LouisSaint LouisUSA
  3. 3.Department of MedicineWashington University in Saint LouisSaint LouisUSA
  4. 4.Department of PsychologyUniversity of Missouri in Saint LouisSaint LouisUSA
  5. 5.Department of Biomedical EngineeringWashington University in Saint LouisSaint LouisUSA

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