Screening for cognitive impairment in human immunodeficiency virus victor valcour. Pdf validation of the international hiv dementia scale as a. Hiv associated dementia aids dementia complex may occur in the late. Original article, human immunodeficiency virus, acquired immunodeficiency syndrome, report by southern african journal of hiv medicine. Hivds dementia scale hivds dementia scale this is an app version of the hiv dementia scale, developed by the johns hopkins hiv neurosciences group as a simple screening tool for hivassociated neurocognitive disorders hand. Jan 31, 2007 international hiv dementia scale from sacktor 2003memoryregistration give four words to recall dog, hat, bean, red translated into the local language in luganda. Hiv dementia screening tools the most commonly referenced hiv screening tool is the hiv dementia scale hds 18. Usefulness of the hiv dementia scale in nigerian patients. This is an app version of the hiv dementia scale, developed by the johns hopkins hiv neurosciences group as a simple screening tool for hiv associated neurocognitive disorders hand. It can be used in a clinic setting and only requires 23 minutes to complete. Ask pt to write alphabet in upper case letters horizontally across the page and record time. Had is an aidsdefining condition with a prevalence in the united states of 21% to 25% before the advent of haart. Usefulness of the hiv dementia scale in nigerian patients with hivaids. Sixtysix hiv positive individuals in the us and 81 hiv positive individuals in uganda received the ihds and full standardized neurological and.
The objective of this study was to evaluate the sensitivity and specificity of a new screening test for hiv dementia, the international hiv dementia scale. We sought to determine whether the mhds and the widely used grooved pegboard gp. This study aimed to examine the classification accuracy of the hds using raw and normbased cutpoints, and to evaluate the contribution of the hds subtests to predicting hand. International hiv dementia scale ihds memoryregistration. Most people dont know that hiv actually makes its way to the brain early in the disease process. Human immunodeficiency virus type 1 hiv associated dementia is the predominant clinical manifestation of hiv in the brain.
Dementia severity rating scale dsrs page 2 of 5 speech and language 0 normal ability to talk and to understand others. Available formats pdf please select a format to send. Repeat words if the patient does not recall them all immediately. To learn more or modifyprevent the use of cookies, see our cookie policy and. Hivassociated neurocognitive disorder hand answers are found in the johns hopkins hiv guide powered by unbound medicine. Patient health questionnaire9 phq9 national hiv curriculum. New limits of intellectual function were recognized very early in hiv aids treatment as a side effect of a patients hiv aids infection, and are now commonly referred to as aids dementia complex adc. In patients with hiv infection or suspected hivassociated dementia, cd4 count and hiv viral load are measured. Studies from 1996 to 2002 in italy estimate rates of cognitive impairment and dementia as 55% and 10%, respectively. Clinical rating scale for symptoms of psychosis in alzheimers disease spad available in source book of geriatric assessment by. About dementia hiv associated dementia this help sheet describes hiv associated dementia and related conditions, their causes, symptoms, diagnosis and treatment. Hivassociated dementia msd manual professional edition. See also overview of delirium and dementia and dementia.
This tool provides a rapid assessment of eye movements, motor skills, simple learning, and attention. Because the basal ganglia are affected, hivassociated cognitive disorders including dementia share many features with diseases such as parkinsons disease and huntington disease. Hiv dementia has an annual incidence of 7% after aids development and eventually affects 20% of all hiv infected persons. We aimed to develop a simpler version of the hdsthe modified hds mhds which would be appropriate for use by nonneurologists. Use of international hiv dementia scale in assessment of.
Diagnostic accuracy of the international hiv dementia scale and hiv dementia. Jan 01, 20 the hiv dementia scale hds was developed to screen for hiv associated neurocognitive disorders hand, but concerns have persisted regarding its substandard sensitivity. Read with interest an article entitled assessment of neurocognitive functions in hiv aids patients on haart using international hiv dementia scale published in int j nutr pharmacol neurol dis 2014. Comparison of the minimental state examination scale and the. International hiv dementia scale ihds mental disorders. The major neurological complication of human immunodeficiency virus type 1 hiv1 infection is cognitive impairment, which can range in severity from a mild subclinical cognitive inefficiency to a severe dementing illness. Mild to moderate cognitive impairment is identified primarily by neuropsychological tests. Diagnostic utility of the international hiv dementia scale for hiv.
The hds performance characteristics are modest with acceptable sensitivity only for the most severe disease. Limitations of the international hiv dementia scale in the. The clinical dementia rating scale cdr is an instrument used in clinical and research settings to assess the severity of alzheimer disease ad. Over the last 2 weeks, how often have you been bothered by the following problems. The early screening neuropsychological tests were designed to assess cortical functions. The value of the hiv dementia scale in vascular mild cognitive impairment, alzheimers and dementia on deepdyve, the largest online rental service for scholarly research with thousands of academic publications available at your fingertips.
Are mmse and hdsr neuropsychological tests adequate for. The use of a crosscultural screening test to detect hiv dementia within the international community is critical for diagnosing this condition. Usefulness of the hiv dementia scale in nigerian patients with hivaids article pdf available in southern african journal of hiv medicine 103. Dementia describes a syndrome involving impairments in thinking, behaviour and the ability to perform everyday tasks. Review article hivaids screening for cognitive impairment in human immunode. The hiv dementia scale hds was developed to screen for hivassociated neurocognitive disorders hand, but concerns have persisted regarding its substandard sensitivity. With the advent of antiretroviral therapy art, the frequency of adc has declined. Hiv aids affects many of the bodys organ systems, including the brain and nervous system.
Diagnostic accuracy of the international hiv dementia scale and. International hiv dementia scale ihds was analyzed using a receiver operating characteristic. Limitations of the international hiv dementia scale in the c. Update on the neurological manifestations of hiv prn. Dementia severity rating scale dsrs page 4 of 5 home activities and responsibilities 0 normal. Although the specific symptoms vary from person to person, they may be part of a single disorder known as aids dementia. Health, general aids patients diseases medical examination psychological aspects dementia care and treatment diagnosis research risk factors prevalence studies. Human immunodeficiency virus hiv is associated with neurological complications, including neurocognitive impairment.
Hence, the international hiv dementia scale ihds was developed to. Hiv dementia scale and psychomotor slowingthe best. Pdf the performance of international hiv dementia scale ihds. The hds includes subtests that evaluate motor speed timed written alphabet, memory recall of four words at 5 min, constructional praxis cube copy time, and executive functions antisaccadic errors subtest. The international hiv dementia scale is a validated brief screening instrument that can be administered by nonneurologists and may detect early motor and cognitive slowing. In patients with suspected or confirmed hiv and dementia, these values help determine how likely hivassociated dementia and cns lymphoma and other hivassociated cns infections is to be contributing to dementia. The study is an important addition to the medical literature on. In late stages of hiv infection, the brain can be compromised, resulting in changes of cognitive abilities. The purpose of the current study was to examine the diagnostic utility of the hiv dementia scale hds and international hiv dementia scale ihds to screen for hand in spanishspeaking adults living with hiv infection. Research article open access prevalence and factors. The hiv dementia scale hds previously has been shown to be sensitive in identifying persons with hiv associated dementia had.
Hivaids is a disease impacting the central nervous system, in which the brain is a major player. Background the hiv dementia scale hds and international hiv. Hivaids affects many of the bodys organ systems, including the brain and nervous system. Here is a short summary about the tool explaining in brief its efficacy. Vascular dementia as a result of infarction of the brain due to vascular disease, including hypertensive cerebrovascular disease.
It can range from asymptomatic neurocognitive impairment ani to minor neurocognitive disorder mnd to more severe hiv associated dementia had also called aids dementia complex adc or hiv encephalopathy. We aimed to develop a simpler version of the hdsthe modified hds. However, questions remain regarding the utility of, optimal population for, and insensitivity of tests in mild hand. In patients with hiv infection or suspected hiv associated dementia, cd4 count and hiv viral load are measured.
We aimed to develop a simpler version of the hdsthe modified hds mhdswhich would be appropriate for use by nonneurologists. International hiv dementia scale and mini mental status. Accurate and early diagnosis of hiv dementia can lead to optimized therapeutic and management decisions. A comprehensive and systematic search was carried out in pubmed and embase databases. Resources for care providers aids institute clinical.
Decline in mental processes is a complication of advanced hiv infection. The hiv dementia scale hds previously has been shown to be sensitive in identifying persons with hivassociated dementia had. Diagnostic utility of the hiv dementia scale and the. Screening for cognitive impairment in human immunode. Some trouble expressing thoughts and giving answers. Are mmse and hdsr neuropsychological tests adequate for screening hivassociated neurocognitive disorders. This aim of this study was to assess the diagnostic accuracy of the international hiv dementia scale ihds or hiv dementia scale hds for the diagnosis of hiv associated neurocognitive disorders hand. Feb 15, 2011 some complications of hiv infection are the direct result of longterm infection, whereas others are the indirect result of aging, antiretroviral therapy, or other patient factors. Human immunodeficiency virus associated dementia is defined by a clinical triad of 1 cognitive deficits, 2 disturbed motor function, and 3 emotional deficits.
Score phq 9 share the phq9 is a multipurpose instrument for screening, diagnosing, monitoring and measuring the severity of depression. This is a bed side screening tool for hiv associated dementia. Hiv dementia has an annual incidence of 7% after aids development and eventually affects 20% of all hivinfected persons. Wendelken, and bruce miller1 1memory andaging center, departmentof neurology, 2divisionof geriatric medicine, department of medicine, university of californiasan francisco.
Hiv associated dementia an overview sciencedirect topics. Cognitive impairmentdementia in hiv patients in a faith. Give 4 words to recall dog, hat, bean, red 1 second to say each. Resources for care providers aids institute clinical guidelines. The clinical dementia rating cdr is a ed instrument of the alzheimers diseases research center, washington university, st. Cognitive impairment in patients with aids prevalence. The national hiv curriculum is an aids education and training center aetc program supported by the health resources and services administration hrsa of the u. May have mor e trouble with money management paying bills and fixing things. In patients with suspected or confirmed hiv and dementia, these values help determine how likely hiv associated dementia and cns lymphoma and other hiv associated cns infections is to be contributing to dementia. The international hiv dementia scale ihds 5 scale was used for measuring probable hiv dementia. Dementia is chronic, global, usually irreversible deterioration of cognition.
Score hiv dementia scale hds previously has been shown to be sensitive in identifying persons with hiv associated dementia had. A score of less than 10 points is an indication of possible hiv dementia. Studies employing the ihds have produced mixed results, with recent data suggesting unusually high rates of dementia among ugandans. Diagnostic accuracy of the international hiv dementia scale. Mar 01, 2017 the prevalence of cognitive impairment dementia in the study population was 70. The global deterioration scale for assessment of primary. Concurrent classification accuracy of the hiv dementia. Hivassociated neurocognitive disorders hand are widely. Human immunodeficiency hiv virus is usually among other disorders associated with cognitive impairment and dementia adding to the burden of the disease in affected individuals and the quality of care.
The test also provides a useful baseline for individuals without any cognitive symptoms. A crosssectional descriptive study was carried out in a nongovernmental organization caring for patients with the disease in jos, north central nigeria. Hiv and dementia health encyclopedia university of. Two crosssectional cohort studies designed to evaluate for the presence of hiv dementia. Health, general aids patients diseases medical examination psychological aspects dementia care and treatment diagnosis research risk factors. The scale registers changes in managing daily activities such as deterioration of faculties misplacing, forgetting, loss of cognition for people, and loss of bodily and toilet functions. The first test is designed to assess memoryregistration, whereby the evaluator says four words e. No decline in ability to do things around the house. Pdf usefulness of the hiv dementia scale in nigerian. Diagnostic accuracy of the international hiv dementia.
First developed by british psychogeriatrician gary blessed in 1968. The global deterioration scale for assessment of primary degenerative dementia the global deterioration scale gds, developed by dr. Clinical rating scale for symptoms of psychosis in alzheimers disease spad available in source book of geriatric assessment by liliane israel must be purchased. Then ask the patient all four words after you have said them. Art may not only prevent or delay the onset of aids dementia complex in people with hiv infection. In addition to being appropriately translated, instruments need to be modified, normed, and validated accordingly. The international hiv dementia scale ihds was developed as a tool to detect hivdementia in both industrialized and resourcelimited settings. Hiv dementia is a subcortical dementia gabrieli, 1995, affecting structure beneath the cerebral cortex.
Ninds airen criteria for the diagnosis of vascular dementia cornell scale for depression in dementia csdd pdf see page 8 geriatric depression scale. Hiv dementia scale and psychomotor slowingthe best methods. Hiv associated neurocognitive disorders hand are commonly observed among patients with hiv infection. Neurological complications associated with hiv and aids. Hiv dementia is an important neurological complication of advanced hiv infection.
For more information on alzheimer disease, see quick lesson about alzheimers disease. Psychiatric rating scales for alzheimers disease and dementia. New limits of intellectual function were recognized very early in hivaids treatment as a side effect of a patients hivaids infection, and are now commonly referred to as aids dementia. Oct 15, 2011 the scope of cognitive disorders in the era of combination antiretroviral therapy. Prior to widespread availability of combination antiretroviral therapy cart, the prevalence of hiv associated dementia was estimated to be between 6 and 30% among patients with aids. The ihds is a modification of the hiv dementia scale first proposed by power et al. For full access to this pdf, sign in to an existing account, or purchase an annual subscription. Concurrent classification accuracy of the hiv dementia scale. Feb 23, 2016 hiv associated neurocognitive disorder hand encompass a hierarchy of progressively more severe patterns of neurological involvement. The authors of this work deserve an appreciation for their effort. However, the incidence of hiv associated dementia had, the most severe form of hand, has markedly decreased after the introduction of the combination antiretroviral therapy cart in mid1990s. Hiv encephalopathy is caused by hiv spreading in the brain and harming it. Hiv associated dementia is chronic cognitive deterioration due to brain infection by hiv.
This aim of this study was to assess the diagnostic accuracy of the international hiv dementia scale ihds or hiv dementia scale hds for the diagnosis of hivassociated neurocognitive disorders hand. Mcarthurs group first conducted some brief cognitive testing, using a simple threeminute series of tests called the modified hiv dementia scale. Hivassociated dementia, a subcortical dementia similar to that seen in huntingtons disease, 41 is severe enough to cause functional impairment, and it has no other definable cause. Diagnostic utility of the hiv dementia scale and the international hiv. Barry reisberg, provides caregivers an overview of the stages of cognitive function for those suffering from a primary degenerative dementia such as alzheimers disease. Hiv associated dementia, a subcortical dementia similar to that seen in huntingtons disease, 41 is severe enough to cause functional impairment, and it has no other definable cause. The major neurological complication of human immunodeficiency virus type 1 hiv 1 infection is cognitive impairment, which can range in severity from a mild subclinical cognitive inefficiency to a severe dementing illness. The cdr dementia staging instrument in one aspect is a 5point scale used to characterize six domains of cognitive and functional performance applicable to alzheimer disease and related dementias.
Screening for cognitive impairment in human immunodeficiency. Sir, read with interest an article entitled assessment of neurocognitive functions in hivaids patients on haart using international hiv dementia scale published in int j nutr pharmacol neurol dis 2014. Using the clinical dementia rating scale what is the clinical dementia rating scale. The international hiv dementia scale ihds was developed as a tool to detect hiv dementia in both industrialized and resourcelimited settings. The implication of these findings is that clinicians should have reasonable index of suspicion when managing patients that are hiv seropositive to be able to identify patients with cognitive problems. Usefulness of the hiv dementia scale in nigerian patients with hiv aids.
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