更新的 HIV 相关认知障碍和痴呆分类诊断算法的操作化。
Operationalization of the updated diagnostic algorithm for classifying HIV-related cognitive impairment and dementia.
机构信息
UCLA Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry and Biobehavioral Sciences, Los Angeles, California, U.S.A.
出版信息
Int Psychogeriatr. 2011 Jun;23(5):835-43. doi: 10.1017/S1041610210002085. Epub 2010 Nov 19.
BACKGROUND
This study applies the updated HIV-Associated Neurocognitive Disorders (HAND) diagnostic algorithm.
METHODS
Participants were 210 HIV-infected-adults, classified using proposed HAND criteria: HIV-Associated Dementia (HAD), Mild Neurocognitive Disorder (MND), Asymptomatic Neurocognitive Impairment (ANI).
RESULTS
The algorithm yielded: normal = 32.8%, ANI = 21.4%, MND = 34.3%, and HAD = 11.4%. Normal participants performed superior to HAND-defined participants on cognition, and HAD participants performed more poorly on global cognition and executive functioning. Two distinct subgroups of interest emerged: (1) functional decline without cognitive impairment; (2) severe cognitive impairment and minimal functional compromise.
CONCLUSIONS
The algorithm discriminates between HIV-infected cognitively impaired individuals. Diagnosis yields two unique profiles requiring further investigation. Findings largely support the algorithm's utility for diagnosing HIV-cognitive-impairment, but suggest distinct subsets of individuals with discrepant cognitive/functional performances that may not be readily apparent by conventional application of HAND diagnosis.
背景
本研究应用了更新的 HIV 相关神经认知障碍 (HAND) 诊断算法。
方法
参与者为 210 名 HIV 感染成年人，使用拟议的 HAND 标准进行分类：HIV 相关痴呆 (HAD)、轻度神经认知障碍 (MND)、无症状神经认知障碍 (ANI)。
结果
该算法得出的结果为：正常=32.8%，ANI=21.4%，MND=34.3%，HAD=11.4%。正常参与者在认知方面的表现优于 HAND 定义的参与者，而 HAD 参与者在整体认知和执行功能方面的表现更差。出现了两个有趣的不同亚组：(1)无认知障碍的功能下降；(2)严重认知障碍和最小的功能障碍。
结论
该算法可区分 HIV 感染认知障碍个体。诊断结果产生了两种独特的特征，需要进一步研究。研究结果在很大程度上支持该算法用于诊断 HIV 认知障碍的效用，但表明存在认知/功能表现不同的个体亚组，这可能不易通过常规 HAND 诊断来发现。
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