Multicenter Study

. 2020 May;21(5):342-348.

doi: 10.1111/hiv.12828. Epub 2019 Dec 27.

How helpful are the European AIDS Clinical Society cognitive screening questions in predicting cognitive impairment in an aging, well-treated HIV-positive population?

M Metral¹, I Nadin^{1

2}, I Locatelli³, P E Tarr⁴, A Calmy⁵, H Kovari⁶, P Brugger⁷, A Cusini⁸, K Gutbrod⁹, P Schmid¹⁰, M Schwind¹¹, U Kunze¹², C Di Benedetto¹³, R Pignatti¹⁴, R Du Pasquier¹, Kea Darling¹⁵, M Cavassini¹⁵; Neurocognitive Assessment in the Metabolic and Aging Cohort (NAMACO) study group, Swiss HIV Cohort Study

Collaborators, Affiliations

Collaborators

Neurocognitive Assessment in the Metabolic and Aging Cohort (NAMACO) study group, Swiss HIV Cohort Study:
Matthias Cavassini, Renaud Du Pasquier, Mélanie Métral, Samanta Simioni, Peter Brugger, Klemens Gutbrod, Andreas U Monsch, Ursi Kunze, Marianne Schneitter, Isaure Nadin, Severin Früh, Marc Schwind, Riccardo Pignatti, Stefanie Clarke, Frédéric Assal, Tobias Derfuss, Sebastian von Arx, Günter Eisele, Leonardo Sacco, Manuel Bertschi, Thomas Hundsberger, Renaud Du Pasquier, Alexandra Calmy, Thanh Doco Lecompte, Christoph Hauser, Alexia Cusini, Rainer Weber, Helen Kovari, Barbara Hasse, Philip Tarr, Marcel Stoeckle, Christoph Fux, Enos Bernasconi, Caroline Di Benedetto, Alessandra Bruno, Patrick Schmid, Katharine Darling, Matthias Cavassini, Alexandra Scherrer, Alexandra Scherrer, Yannick Vallet, Deolinda Alves, Isabella Locatelli, Laurent Decosterd, Cristina Granziera, Gunnar Krueger, Reto Meuli, Maria Vargas, K Aebi-Popp, A Anagnostopoulos, M Battegay, E Bernasconi, J Böni, D L Braun, H C Bucher, A Calmy, M Cavassini, A Ciuffi, G Dollenmaier, M Egger, L Elzi, J Fehr, J Fellay, H Furrer, C A Fux, H F Günthard, D Haerry, B Hasse, H H Hirsch, M Hoffmann, I Hösli, M Huber, C R Kahlert, L Kaiser, O Keiser, T Klimkait, R D Kouyos, H Kovari, B Ledergerber, G Martinetti, B Martinez de Tejada, C Marzolini, K J Metzner, N Müller, D Nicca, P Paioni, G Pantaleo, M Perreau, A Rauch, C Rudin, A U Scherrer, P Schmid, R Speck, M Stöckle, P Tarr, A Trkola, P Vernazza, G Wandeler, R Weber, S Yerly

Affiliations

¹ Service of Neurology, Department of Clinical Neurosciences, Lausanne, Switzerland.
² Service of Neurology, University Hospital of Geneva, Geneva, Switzerland.
³ Department of Ambulatory Care and Community Medicine, University of Lausanne, Lausanne, Switzerland.
⁴ University Department of Medicine, Kantonsspital Bruderholz, University of Basel, Bruderholz, Switzerland.
⁵ HIV Unit, Infectious Diseases Division, Department of Medicine, University Hospital of Geneva, Geneva, Switzerland.
⁶ Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, Zurich, Switzerland.
⁷ Neuropsychology Unit, Department of Neurology, University Hospital Zurich, Zurich, Switzerland.
⁸ Department of Infectious Diseases and Hospital Epidemiology, Bern University Hospital and University of Bern, Bern, Switzerland.
⁹ Division of Neurology, Bern University Hospital and University of Bern, Bern, Switzerland.
¹⁰ Infectious Diseases and Hospital Epidemiology Division, Kantonsspital St Gallen, St Gallen, Switzerland.
¹¹ Neurology Clinic, St. Gallen, Switzerland.
¹² Memory Clinic, Felix Platter Hospital, University Center for Medicine of Aging, Basel, Switzerland.
¹³ Infectious Diseases Unit, Lugano Regional Hospital, Lugano, Switzerland.
¹⁴ Department of Neurology, Neurocentre of Southern Switzerland, Lugano Regional Hospital, Lugano, Switzerland.
¹⁵ Service of Infectious Diseases, Lausanne University Hospital, Lausanne, Switzerland.

PMID: 31883203
PMCID: PMC7216878
DOI: 10.1111/hiv.12828

Multicenter Study

How helpful are the European AIDS Clinical Society cognitive screening questions in predicting cognitive impairment in an aging, well-treated HIV-positive population?

M Metral et al. HIV Med. 2020 May.

. 2020 May;21(5):342-348.

doi: 10.1111/hiv.12828. Epub 2019 Dec 27.

Authors

Collaborators

Neurocognitive Assessment in the Metabolic and Aging Cohort (NAMACO) study group, Swiss HIV Cohort Study:
Matthias Cavassini, Renaud Du Pasquier, Mélanie Métral, Samanta Simioni, Peter Brugger, Klemens Gutbrod, Andreas U Monsch, Ursi Kunze, Marianne Schneitter, Isaure Nadin, Severin Früh, Marc Schwind, Riccardo Pignatti, Stefanie Clarke, Frédéric Assal, Tobias Derfuss, Sebastian von Arx, Günter Eisele, Leonardo Sacco, Manuel Bertschi, Thomas Hundsberger, Renaud Du Pasquier, Alexandra Calmy, Thanh Doco Lecompte, Christoph Hauser, Alexia Cusini, Rainer Weber, Helen Kovari, Barbara Hasse, Philip Tarr, Marcel Stoeckle, Christoph Fux, Enos Bernasconi, Caroline Di Benedetto, Alessandra Bruno, Patrick Schmid, Katharine Darling, Matthias Cavassini, Alexandra Scherrer, Alexandra Scherrer, Yannick Vallet, Deolinda Alves, Isabella Locatelli, Laurent Decosterd, Cristina Granziera, Gunnar Krueger, Reto Meuli, Maria Vargas, K Aebi-Popp, A Anagnostopoulos, M Battegay, E Bernasconi, J Böni, D L Braun, H C Bucher, A Calmy, M Cavassini, A Ciuffi, G Dollenmaier, M Egger, L Elzi, J Fehr, J Fellay, H Furrer, C A Fux, H F Günthard, D Haerry, B Hasse, H H Hirsch, M Hoffmann, I Hösli, M Huber, C R Kahlert, L Kaiser, O Keiser, T Klimkait, R D Kouyos, H Kovari, B Ledergerber, G Martinetti, B Martinez de Tejada, C Marzolini, K J Metzner, N Müller, D Nicca, P Paioni, G Pantaleo, M Perreau, A Rauch, C Rudin, A U Scherrer, P Schmid, R Speck, M Stöckle, P Tarr, A Trkola, P Vernazza, G Wandeler, R Weber, S Yerly

Affiliations

¹ Service of Neurology, Department of Clinical Neurosciences, Lausanne, Switzerland.
² Service of Neurology, University Hospital of Geneva, Geneva, Switzerland.
³ Department of Ambulatory Care and Community Medicine, University of Lausanne, Lausanne, Switzerland.
⁴ University Department of Medicine, Kantonsspital Bruderholz, University of Basel, Bruderholz, Switzerland.
⁵ HIV Unit, Infectious Diseases Division, Department of Medicine, University Hospital of Geneva, Geneva, Switzerland.
⁶ Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, Zurich, Switzerland.
⁷ Neuropsychology Unit, Department of Neurology, University Hospital Zurich, Zurich, Switzerland.
⁸ Department of Infectious Diseases and Hospital Epidemiology, Bern University Hospital and University of Bern, Bern, Switzerland.
⁹ Division of Neurology, Bern University Hospital and University of Bern, Bern, Switzerland.
¹⁰ Infectious Diseases and Hospital Epidemiology Division, Kantonsspital St Gallen, St Gallen, Switzerland.
¹¹ Neurology Clinic, St. Gallen, Switzerland.
¹² Memory Clinic, Felix Platter Hospital, University Center for Medicine of Aging, Basel, Switzerland.
¹³ Infectious Diseases Unit, Lugano Regional Hospital, Lugano, Switzerland.
¹⁴ Department of Neurology, Neurocentre of Southern Switzerland, Lugano Regional Hospital, Lugano, Switzerland.
¹⁵ Service of Infectious Diseases, Lausanne University Hospital, Lausanne, Switzerland.

PMID: 31883203
PMCID: PMC7216878
DOI: 10.1111/hiv.12828

Abstract

Objectives: Diagnosing neurocognitive impairment (NCI) in HIV infection requires time-consuming neuropsychological assessment. Screening tools are needed to identify when neuropsychological referral is indicated. We examined the positive and negative predictive values (PPVs and NPVs, respectively) of the three European AIDS Clinical Society (EACS) screening questions in identifying NCI.

Methods: The Neurocognitive Assessment in the Metabolic and Aging Cohort (NAMACO) study recruited patients aged ≥45 years enrolled in the Swiss HIV Cohort Study between 1 May 2013 and 30 November 2016. NAMACO participants (1) answered EACS screening questions, (2) underwent standardized neuropsychological assessment and (3) completed self-report forms [Center for Epidemiologic Studies Depression Scale (CES-D)] rating mood. NCI categories were defined using Frascati criteria. PPVs and NPVs of the EACS screening questions in identifying NCI categories were calculated.

Results: Of 974 NAMACO participants with complete EACS screening question data, 244 (25.1%) expressed cognitive complaints in answer to at least one EACS screening question, of whom 51.3% had NCI (26.1% HIV-associated and 25.2% related to confounding factors). The PPV and NPV of the EACS screening questions in identifying HIV-associated NCI were 0.35 and 0.7, respectively. Restricting analysis to NCI with functional impairment or related to confounding factors, notably depression, the NPV was 0.90. Expressing cognitive complaints for all three EACS screening questions was significantly associated with depression (P < 0.001).

Conclusions: The EACS screening questions had an NPV of 0.7 for excluding patients with HIV-associated NCI as defined by Frascati criteria. The PPV and NPV may improve if NCI diagnoses are based on new criteria.

Keywords: HIV and aging; neurocognitive impairment; neuropsychological testing; predictive values; screening.

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Figures

**Figure 1**
Prevalence of neurocognitive impairment among all study participants, those with cognitive complaints and those without complaints. NCI, neurocognitive impairment; ANI, asymptomatic neurocognitive impairment; MND, mild neurocognitive disorder; HAD, HIV‐associated dementia; *other*, neurocognitive impairment related to confounders other than those associated with HIV infection.

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Comment in

Authors' reply to A. Winston, A. Cotter, M. Gisslen, P. W. G. Mallon and P. Cinque.
Darling K, Métral M, Du Pasquier R, Cavassini M; Neurocognitive Assessment in the Metabolic and Aging Cohort (NAMACO) Study Group Swiss HIV Cohort Study. Darling K, et al. HIV Med. 2020 Aug;21(7):e19-e20. doi: 10.1111/hiv.12875. Epub 2020 May 18. HIV Med. 2020. PMID: 32420665 No abstract available.
Response to: 'How helpful are the European AIDS Clinical Society cognitive screening questions in predicting cognitive impairment in an aging, well-treated HIV-positive population?'.
Winston A, Cotter A, Gisslen M, Mallon P, Cinque P. Winston A, et al. HIV Med. 2020 Aug;21(7):e17-e18. doi: 10.1111/hiv.12874. Epub 2020 May 22. HIV Med. 2020. PMID: 32441846 No abstract available.

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How helpful are the European AIDS Clinical Society cognitive screening questions in predicting cognitive impairment in an aging, well-treated HIV-positive population?

Collaborators

Affiliations

How helpful are the European AIDS Clinical Society cognitive screening questions in predicting cognitive impairment in an aging, well-treated HIV-positive population?

Authors

Collaborators

Affiliations

Abstract

Figures

Comment in

References

Publication types

MeSH terms

LinkOut - more resources

Full Text Sources

Medical