Department of Medicine, University of Alabama Birmingham, CCB Rm 325, 908 20th St South, Birmingham, AL 35294, USA.
J Neurovirol. 2013 Feb;19(1):109-16. doi: 10.1007/s13365-012-0147-5. Epub 2013 Jan 24.
The diagnosis of human immunodeficiency virus (HIV)-associated neurocognitive impairment is time-intensive and often omitted in busy outpatient settings. Brief screening tools are needed. The Montreal Cognitive Assessment (MoCA) and the Alzheimer's disease (AD)-8 have been used in neurodegenerative disorders. We evaluated the sensitivity and specificity of these brief screening tools in HIV-infected persons. The AD-8, MoCA, and formal neuropsychological testing were administered to 200 HIV-infected patients who were followed at a single institution. Normalized scores on formal neuropsychological testing were used to define neurocognitive impairment. The sensitivity and specificity of the MoCA and AD-8 were assessed to diagnose the impairment. Neurocognitive impairment was highly prevalent in this cohort: 127 persons (64 %) were diagnosed with neurocognitive impairment based on formal testing. Using the AD-8 and MoCA, 113 (57 %) and 101 (51 %) persons were identified with neurocognitive impairment, respectively. The sensitivity and specificity of MoCA were 63 % and 71 %, respectively. The sensitivity and specificity of AD-8 were 61 % and 51 %, respectively. Our findings highlight that brief screening tools correlate with formal neuropsychological testing. However, the sensitivities of these screening tools are lower than desired. Nevertheless, given their ease in administration, these tools could assist as a first line for identifying individuals who may subsequently require formal neuropsychological testing.
人类免疫缺陷病毒（HIV）相关神经认知障碍的诊断耗时且在繁忙的门诊环境中经常被省略。因此需要使用简短的筛选工具。蒙特利尔认知评估（MoCA）和阿尔茨海默病（AD）-8 已在神经退行性疾病中使用。我们评估了这些简短的筛选工具在 HIV 感染者中的敏感性和特异性。AD-8、MoCA 和正式的神经心理学测试被用于在一家机构接受随访的 200 名 HIV 感染者。正式神经心理学测试的标准化分数用于定义神经认知障碍。评估了 MoCA 和 AD-8 的敏感性和特异性以诊断损伤。该队列中神经认知障碍的患病率很高：根据正式测试，127 人（64%）被诊断为神经认知障碍。使用 AD-8 和 MoCA，分别有 113 人（57%）和 101 人（51%）被诊断为神经认知障碍。MoCA 的敏感性和特异性分别为 63%和 71%。AD-8 的敏感性和特异性分别为 61%和 51%。我们的研究结果表明，简短的筛选工具与正式的神经心理学测试相关。然而，这些筛选工具的敏感性低于预期。尽管如此，由于它们易于管理，这些工具可以作为识别可能随后需要进行正式神经心理学测试的个体的第一线。
