Concordance Between Self-Report and Performance-Based Measures of Everyday Functioning in HIV-Associated Neurocognitive Disorders
Overview
Authors
Affiliations
Self-report is typically used to differentiate between asymptomatic neurocognitive impairment (ANI) and mild neurocognitive disorder (MND) in the assessment of HIV-associated neurocognitive disorders (HAND). Yet, it is unclear whether the lack of self-reported functional impairments in individuals with ANI is indicative of a genuine absence of functional impairment, or of inaccurate self-reports. In the present study, we examined the relationship between previously validated self-report (patient's assessment of own functioning inventory; instrumental activities of daily living inventory) and performance-based (the Texas Functional Living Scale) measures of functional abilities in 112 virologically-controlled HIV-infected, and 40 well-matched, HIV-uninfected participants. Participants with symptomatic cognitive impairment (CI) had significantly lower overall scores and higher rates of impairment on a performance-based measure of everyday functioning as compared to participants with either asymptomatic CI or normal cognitive performance (WNL [within normal limits]; all p < 0.05), while asymptomatic CI and WNL participants had comparable rates of impairment and performance within the average range on the performance-based measure. The concordance between self-report and performance-based measures of everyday functioning in asymptomatic and symptomatic CI provide support for ANI and MND as clinically distinct diagnostic entities, and support the use of self-reports as appropriate measures of everyday functioning in the diagnosis of HAND.
McMahan C, Dietrich D, Horne E, Kelly E, Geannopoulos K, Siyahhan Julnes P Neurology. 2023; 100(24):e2466-e2476.
PMID: 37105760 PMC: 10264056. DOI: 10.1212/WNL.0000000000207339.
Age, cognitive status, and accuracy of ADL self-reports in adults living with HIV.
Clarke Y, Morgello S, Byrd D AIDS Care. 2022; 35(2):289-295.
PMID: 36007132 PMC: 11246603. DOI: 10.1080/09540121.2022.2113759.
Kim T, Samet J, Lodi S, Kimmel S, Forman L, Lira M AIDS Behav. 2022; 26(12):3889-3896.
PMID: 35737281 PMC: 11055610. DOI: 10.1007/s10461-022-03716-3.
Association of White Matter Hyperintensities With HIV Status and Vascular Risk Factors.
Mina Y, Wu T, Hsieh H, Hammoud D, Shah S, Lau C Neurology. 2021; 96(14):e1823-e1834.
PMID: 33637630 PMC: 8105972. DOI: 10.1212/WNL.0000000000011702.
Paul R, Garcia-Egan P, Bolzenius J, Mannarino J Curr Top Behav Neurosci. 2021; 50:245-269.
PMID: 33442841 DOI: 10.1007/7854_2020_185.