Open AccessImpaired Neurocognitive Performance and Mortality in HIV: Assessing the Prognostic Value of the HIV-Dementia Scale
Author(s) -
Nikhil Banerjee,
Roger C. McIntosh,
Gail Ironson
Publication year - 2019
Publication title -
aids and behavior
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.994
H-Index - 106
eISSN - 1573-3254
pISSN - 1090-7165
DOI - 10.1007/s10461-019-02423-w
Subject(s) - neurocognitive , human immunodeficiency virus (hiv) , health psychology , dementia , public health , medicine , scale (ratio) , clinical psychology , psychiatry , psychology , gerontology , immunology , cognition , disease , pathology , geography , cartography
This study examined whether global HIV-associated neurocognitive impairment (NCI), assessed with the HIV-Dementia Scale (HDS), predicted mortality in an ethnically diverse sample of 209 HIV-positive adults. Participants were predominantly in the mid-range of illness at baseline, and followed over 13-years. At baseline, 31 (15%) participants scored in the NCI range (HDS ≤ 10); 58 (28%) died during follow-up. Baseline NCI was significantly associated with earlier mortality (HR = 2.10, 95% CI [1.10-4.00]) independent of sociodemographic and HIV disease-related covariates. Less errors on the antisaccade task, an index of executive/attention control, was the only HDS subtest predicting earlier mortality (HR = 0.72, 95% CI [0.58-0.90]). In the absence of an AIDS-defining condition, NCI, particularly in the executive/attention domain, is an independent prognostic marker of mortality in a diverse HIV-positive cohort. These findings highlight the clinical utility of brief cognitive screening measures in this population.