The Research Institute of the McGill University Health Centre, Montreal, Quebec.
HIV Med. 2011 Sep;12(8):472-80. doi: 10.1111/j.1468-1293.2010.00910.x. Epub 2011 Mar 13.
Existing tools for rapid cognitive assessment in HIV-positive individuals with mild cognitive deficits lack sensitivity or do not meet psychometric requirements for tracking changes in cognitive ability over time.
Seventy-five nondemented HIV-positive patients were evaluated with the Montreal Cognitive Assessment (MoCA), a brief battery of standardized neuropsychological tests, and computerized tasks evaluating frontal-executive function and processing speed. Rasch analyses were applied to the MoCA data set and subsequently to the full set of data from all tests.
The MoCA was found to adequately measure cognitive ability as a single, global construct in this HIV-positive cohort, although it showed poorer precision for measuring patients of higher ability. Combining the additional tests with the MoCA resulted in a battery with better psychometric properties that also better targeted the range of abilities in this cohort.
This application of modern test development techniques shows a path towards a quick, quantitative, global approach to cognitive assessment with promise both for initial detection and for longitudinal follow-up of cognitive impairment in patients with HIV infection.
现有的用于评估 HIV 阳性个体轻度认知障碍的快速认知工具敏感性不足，或者不符合在一段时间内跟踪认知能力变化的心理计量学要求。
对 75 名非痴呆 HIV 阳性患者进行了蒙特利尔认知评估（MoCA）、一套简短的标准化神经心理测试以及用于评估额叶执行功能和处理速度的计算机任务的评估。对 MoCA 数据集进行了 Rasch 分析，随后对所有测试的全部数据进行了分析。
研究发现，MoCA 能够充分测量 HIV 阳性队列中认知能力这一单一、整体的结构，但它在测量高能力患者时的精度较差。将额外的测试与 MoCA 相结合，形成了一个具有更好心理计量学特性的测试组合，该组合还更好地针对了该队列的能力范围。
这种现代测试开发技术的应用为快速、定量、全面的认知评估提供了一种方法，在 HIV 感染者的认知障碍的初步检测和纵向随访方面都具有很大的潜力。
