Department of Psychology, University of Miami, 5665 Ponce de Leon Blvd., Coral Gables, FL, 33124-0751, USA.
AIDS Behav. 2019 Dec;23(12):3482-3492. doi: 10.1007/s10461-019-02423-w.
This study examined whether global HIV-associated neurocognitive impairment (NCI), assessed with the HIV-Dementia Scale (HDS), predicted mortality in an ethnically diverse sample of 209 HIV-positive adults. Participants were predominantly in the mid-range of illness at baseline, and followed over 13-years. At baseline, 31 (15%) participants scored in the NCI range (HDS ≤ 10); 58 (28%) died during follow-up. Baseline NCI was significantly associated with earlier mortality (HR = 2.10, 95% CI [1.10-4.00]) independent of sociodemographic and HIV disease-related covariates. Less errors on the antisaccade task, an index of executive/attention control, was the only HDS subtest predicting earlier mortality (HR = 0.72, 95% CI [0.58-0.90]). In the absence of an AIDS-defining condition, NCI, particularly in the executive/attention domain, is an independent prognostic marker of mortality in a diverse HIV-positive cohort. These findings highlight the clinical utility of brief cognitive screening measures in this population.
本研究旨在探讨全球 HIV 相关神经认知障碍（NCI），采用 HIV 痴呆量表（HDS）评估，是否能预测 209 名 HIV 阳性成年人的死亡率。参与者在基线时主要处于疾病的中程范围，随访时间超过 13 年。基线时，31 名（15%）参与者的 NCI 评分处于 NCI 范围（HDS≤10）；58 名（28%）在随访期间死亡。基线 NCI 与更早的死亡率显著相关（HR=2.10，95%CI[1.10-4.00]），独立于社会人口统计学和 HIV 疾病相关协变量。反扫视任务的错误较少，这是执行/注意力控制的指标，是唯一预测更早死亡率的 HDS 子测试（HR=0.72，95%CI[0.58-0.90]）。在没有 AIDS 定义的情况下，NCI，特别是在执行/注意力领域，是一个多样化的 HIV 阳性队列死亡率的独立预后标志物。这些发现强调了在该人群中使用简短认知筛查措施的临床实用性。
