Evaluating the accuracy of self-report for the diagnosis of HIV-associated neurocognitive disorder (HAND): defining "symptomatic" versus "asymptomatic" HAND.
J Neurovirol
; 23(1): 67-78, 2017 02.
Article
en En
| MEDLINE
| ID: mdl-27557777
ABSTRACT
The criteria for differentiating symptomatic from asymptomatic HIV-associated neurocognitive disorder require evaluation of (1) cognitive impairment, (2) daily functioning declines, and (3) whether the functional declines are attributable to cognitive versus physical problems. Many providers rely only on self-report to evaluate these latter criteria. However, the accuracy of patient-provided information may be limited. This study evaluated the validity of self-assessment for HIV-associated neurocognitive disorder (HAND) diagnoses by comparing objective findings with self-report of criteria 2 and 3 above. Self-reports were used to stratify 277 cognitively impaired HIV+ individuals into functionally dependent (n = 159) and independent (n = 118) groups, followed by group comparisons of objective functional problems. The dependent group was then divided into those who self-attributed their functional dependence to only cognitive (n = 80) versus only physical (n = 79) causes, for further comparisons on objective findings. The functionally dependent group was significantly worse than the independent group on all objective disability characteristics except severity of cognitive impairment, while those who attributed their dependence to physical (versus cognitive) factors were similar on all objective physical, cognitive, and functioning variables. Of note, 28 % of physical attributors showed no physical abnormalities on neuromedical examinations. Results suggest that patient report is consistently associated with objective measures of functional loss; in contrast, patient identification of physical versus cognitive causes is poorly associated with objective criteria. These findings caution against relying solely on patient self-report to determine whether functional disability in cognitively impaired HIV+ individuals can be attributed to strictly physical causes.
Palabras clave
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Actividades Cotidianas
/
Infecciones por VIH
/
Personas con Discapacidad
/
Autoinforme
/
Disfunción Cognitiva
Tipo de estudio:
Diagnostic_studies
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Adult
/
Female
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Humans
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Male
/
Middle aged
Idioma:
En
Revista:
J Neurovirol
Asunto de la revista:
NEUROLOGIA
/
VIROLOGIA
Año:
2017
Tipo del documento:
Article
País de afiliación:
Estados Unidos