Validity of the international hiv dementia scale in south africa article pdf available in aids patient care and stds 252. The purpose of this study was to design a valid instrument to identify hiv dementia. Method and subjects the hiv dementia scale was developed by c. Human immunodeficiency virus associated dementia is defined by a clinical triad of 1 cognitive deficits, 2 disturbed motor function, and 3 emotional deficits. This scale requires training to administer and may not be preferable for use in a clinical setting. Functional disability in medication management and driving among. Thinking, memory, judgement, concentration, and motor function may all suffer as a result of this condition.
Sixtysix hiv positive individuals in the us and 81 hiv positive individuals in uganda received the ihds and full standardized neurological and. The hds performance characteristics are modest with acceptable sensitivity only for the most severe disease. Hiv dementia scale and psychomotor slowingthe best. We do not know exactly how the virus damages brain cells.
Hivassociated asymptomatic neurocognitive impairment. Had is an aidsdefining condition with a prevalence in the united states of 21% to 25% before the advent of haart. Hivassociated neurocognitive disorders hand is a neurological complication of an advanced hiv infection. While this is useful in the diagnosis of had, it may miss the milder. Spanish validation of the hiv dementia scale in women. The hds has been shown to be an adequate screening tool in hiv. Validity of the international hiv dementia scale in brazil scielo. Alzheimers disease is the most common cause of dementia, but there are many rarer diseases and conditions that can lead to dementia, dementia like symptoms or mild cognitive impairment. Examples include the hiv dementia scale hds, the modi. A brief discussion of the mental problems associated with hiv part of the daily living program on mental health, from the va national hiv aids website. This is an app version of the hiv dementia scale, developed by the johns hopkins hiv neurosciences group as a simple screening tool for hiv associated neurocognitive disorders hand. Apply for and manage the va benefits and services youve earned as a veteran, servicemember, or family memberlike health care, disability, education, and more. Pdf abstract introduction availability of haart has improved the outcome of hivassociated neurocognitive disorders hand though the. Pdf usefulness of the hiv dementia scale in nigerian.
The study hypothesis was that there is a significant difference in the detection of hand when mmse is used compared to the ihds scale. Validity of the international hiv dementia scale as assessed. International hiv dementia scale ihds here is a short summary about the tool explaining in brief its efficacy. Pdf the performance of international hiv dementia scale ihds. Dementia severity rating scale dsrs page 2 of 5 speech and language 0 normal ability to talk and to understand others. An example of such a short screening test is the hiv dementia scale hds power et al. Here is a short summary about the tool explaining in brief its efficacy. Diagnostic accuracy of the international hiv dementia scale and.
Sacktor, professor of neurology, johns hopkins medicine. The development of a japanese version of the hiv dementia. Validation of the international hiv dementia scale as a screening. Score hivassociated neurocognitive disorders hand scale. The purpose of this study was to develop such a new neuropsychological test in japanese and con. The greater the spread of infection in the brain and the more damage that results, the worse the dementia symptoms become. They are increasingly being used in clinical practice for minor neurocognitive disorder mnd as well as had, despite uncertainty about their accuracy.
In patients with suspected or confirmed hiv and dementia, these values help determine how likely hiv associated dementia and cns lymphoma and other hiv associated cns infections is to be contributing to dementia. The modified hiv dementia scale omits the attention category and may be more suitable for administration by a physician. Comparison of the minimental state examination scale and the. Then ask the patient all four words after you have said them.
Sometimes this disease is called hiv encephalopathy or aids dementia when the symptoms are severe. Aids dementia is also called aids dementia complex or hiv linked dementia. The hds is a reliable and quantitative scale that is superior to other widely used bedside tests such as the mmse for identifying hiv dementia. Aids dementia complex is caused by the hiv virus itself, not by the opportunistic infections that occur commonly in advanced hiv. Hiv dementia screening tools the most commonly referenced hiv screening tool is the hiv dementia scale hds 18. The authors identified a score of 3 as the optimal cutpoint when using the phq2 to screen for depression. Diagnostic utility of the hiv dementia scale and the international hiv.
Apa resolution on neuropsychological assessment of persons. Concurrent classification accuracy of the hiv dementia scale for hiv associated neurocognitive disorders in the charter cohort. The performance of international hiv dementia scale ihds versus. People in the later stages can have seizures, psychosis, and loss of bladder or bowel control. Hiv associated dementia an overview sciencedirect topics. The validity of the ihds was established using a receiver operating characteristic roc analysis.
Hiv associated dementia, a subcortical dementia similar to that seen in huntingtons disease, 41 is severe enough to cause functional impairment, and it has no other definable cause. The hiv dementia scale hds has been recommended as a crosssectional screen for hiv associated neurocognitive disorder hand but its longitudinal usefulness has not been optimally established. Hivassociated neurocognitive disorder hand johns hopkins. The performance of international hiv dementia scale ihds versus mini mental status examition scale mmse in assessment of. It is one cause of dementia in people who have hiv.
The performance of international hiv dementia scale ihds versus mini mental status examition scale mmse in assessment of hiv associated neurocognitive disorders hand among hiv infected. In the prehaart era, the hiv dementia scale hds was developed and subsequently modified for use in international settings as the international hiv dementia scale ihds. Score hiv associated neurocognitive disorders hand is a neurological complication of an advanced hiv infection. Validity of the international hiv dementia scale in south. Hivassociated neurocognitive disorder hand alzheimer. Hiv and dementia health encyclopedia university of. Score dementia complex is caused by the hiv virus itself, not by the opportunistic infections that occur commonly in advanced hiv. The hiv dementia scale hds was developed to screen for hiv associated neurocognitive disorders hand, but concerns have persisted regarding its substandard sensitivity. Hiv ds dementia scale hiv ds dementia scale this is an app version of the hiv dementia scale, developed by the johns hopkins hiv neurosciences group as a simple screening tool for hiv associated neurocognitive disorders hand. The national hiv curriculum is an aids education and training center program and led by the university of washington.
In late stages of hiv infection, the brain can be compromised, resulting in changes of cognitive abilities. Aids, cognitive disorders, dementia, infectious disease. Neither test is sensitive enough to detect minor impairment, or to determine different stages of aids dementia. Cognitive impairment in patients with aids prevalence. Art may not only prevent or delay the onset of aids dementia complex in people with hiv infection. Pdf spanish validation of the hiv dementia scale in women.
It is quick and does not require a neurologist to administer it. In patients with hiv infection or suspected hiv associated dementia, cd4 count and hiv viral load are measured. About dementia hiv associated dementia this help sheet describes hiv associated dementia and related conditions, their causes, symptoms, diagnosis and treatment. Hivassociated neurocognitive dysfunction hand and related. Hivassociated neurocognitive disorder hand alzheimers. Hivassociated neurocognitive disorder in a kwazulu southern. Of these tests, the hiv dementia scale hds developed by power et al. Usefulness of the hiv dementia scale in nigerian patients with hivaids. Diagnostic utility of the hiv dementia scale and the international hiv dementia scale in screening for hivassociated neurocognitive disorders among spanishspeaking adults enrique lopez, a, b alexander j. However, clinical experience in utilizing the scale with large chinese samples is currently lacking, especially among individuals with limited formal schooling. Concurrent classification accuracy of the hiv dementia.
It is most common in people who are not on effective hiv medications and when the cd4 cell count is very low. Pdf validity of the international hiv dementia scale in. Hiv infected patients have been developed over the years valcour et al. This study aimed to examine the classification accuracy of the hds using raw and normbased cutpoints, and to evaluate the contribution of the hds subtests to predicting hand. International hiv dementia scale from sacktor 2003 memoryregistration give four words to recall dog, hat, bean, red translated into the local language in luganda. Repeat words if the patient does not recall them all immediately. We aimed to develop a simpler version of the hdsthe modified hds mhdswhich would be appropriate for use by nonneurologists. Pdf the performance of international hiv dementia scale. The efficiencies of each instrument for identifying hiv dementia were as follows. Jan 31, 2007 international hiv dementia scale from sacktor 2003memoryregistration give four words to recall dog, hat, bean, red translated into the local language in luganda.
Questionnaire used to evaluate neurological abnormalities. Hiv dementia is an important neurological complication of advanced hiv infection. Screening tools such as the montreal cognitive assessment moca or the hiv dementia scale can be helpful in identifying hand. Two crosssectional cohort studies designed to evaluate for the presence of hiv dementia. The provider should use it as a guide and demonstrate all actions to the patient with their own hands. The objective of this study was to evaluate the sensitivity and specificity of a new screening test for hiv dementia, the international hiv dementia scale. Hiv can invade the brain and cause a variety of symptoms. If the score is 3 or greater, major depressive disorder is likely. New limits of intellectual function were recognized very early in hiv aids treatment as a side effect of a patients hiv aids infection, and are now commonly referred to as aids dementia complex adc. Pdf spanish validation of the hiv dementia scale in.
This module is for any health care provider who would like to establish core competence in testing for hiv, recognizing acute hiv infection, and linking persons diagnosed with hiv. The use of a crosscultural screening test to detect hiv dementia within the international community is critical for diagnosing this condition. The hiv dementia scale is useful to assess degree of hiv dementia and for longitudinal followup. With the advent of antiretroviral therapy art, the frequency of adc has declined. Richardson, ma, morgan, ee, vielhauer, mj, et al 2005 utility of the hiv dementia scale in assessing risk for significant hiv related cognitivemotor deficits in a. The performance of international hiv dementia scale ihds versus mini mental status examition scale mmse in assessment of hivassociated neurocognitive disorders hand among hivinfected. Questionnaire, questionnaire used to evaluate neurological abnormalities. A brief discussion of the mental problems associated with hiv part of the daily living program on mental health, from the va national hivaids website. The hds focuses on four major areas of neurological functioning. The international hiv dementia scale ihds was developed by dr. The hiv dementia scale hds previously has been shown to be sensitive in identifying persons with hiv associated dementia had.
A hiv dementia scale that assesses cognitive symptoms is sometimes administered. Hand refers to hiv associated neurocognitive disorder and refers to dysfunction of any degree of severity from asymptomatic neurocognitive impairment to mild neurocognitive disorder to hiv associated dementia had. Human immunodeficiency virus type 1 hiv associated dementia is the predominant clinical manifestation of hiv in the brain. This form really limits someones ability to lead a normal life. The international hiv dementia scale ihds is a crosscultural screening test to detect hiv dementia. This test consists of items addressing memory, attention, psychomotor functioning, and visuoconstruction.
Download the moca pdf download the international dementia scale pdfread more. Ten out of eleven patients were on antiretroviral medication and none scored within the demented range on the hiv dementia scale. Hiv associated neurocognitive disorders are associated with a metabolic encephalopathy induced by hiv infection and fueled by immune activation of macrophages and microglia. Diagnostic utility of the hiv dementia scale and the international hiv dementia scale. Validity of the montreal cognitive assessment and the hiv. The international hiv dementia scale ihds, a simple and pragmatic assessment tool developed. Hiv associated dementia when someone has the human immunodeficiency virus hiv and acquired immune deficiency syndrome aids they may develop a complication to the disease which is known as hiv associated dementia, or as aids dementia complex adc. Diagnostic accuracy of the international hiv dementia scale and hiv.
The international hiv dementia scale ihds has until now been a. Diagnostic utility of the hiv dementia scale and the international hiv dementia scale in screening for hivassociated. Hiv associated neurocognitive disorder hand is a sample topic from the johns hopkins hiv guide. The condition is associated with severe cognitive, motor and behavioural problems that impair day to day functioning, reducing independence and quality of life. The international hiv dementia scale ihds was administered together with a detailed neuropsychological test battery to 96 hiv positive individuals who had not received art and who were attending primary care hiv clinics. Patients who screen positive should be further evaluated with the phq9, other diagnostic instruments, or direct interview to determine.
The national hiv curriculum is an aids education and training center aetc program supported by the health resources and services administration hrsa of the u. Accurate and early diagnosis of hiv dementia can lead to optimized therapeutic and management decisions. These cells are actively infected with hiv and secrete neurotoxins of both host and viral origin. It was initially tested on hiv patients from the usa and uganda, with reported sensitivity and specificity of 80 and 55%, respectively1. The international hiv dementia scale is a relatively simpletoadminister screening scale for hiv associated neurocognitive disorders. The hiv dementia scale hds and international hiv dementia scale ihds are brief tools that have been developed to screen for and aid diagnosis of hiv associated dementia had. When cognitive functions are mildly affected and this interferes with work, home or social 19 national dementia helpline 1800 100 500 dementia. International hiv dementia scale ihds mental disorders. Spanish validation of the hiv dementia scale in women article pdf available in aids patient care and stds 2112.
International hiv dementia scale ihds mental disorders screening. Journal of acquired immune deficiency syndrome, 621, 3642. Concurrent classification accuracy of the hiv dementia scale for hivassociated neurocognitive disorders in the charter cohort. Screening tools such as the montreal cognitive assessment moca or the international dementia scale can be helpful in identifying hand. Hiv dementia scale and psychomotor slowingthe best methods. The test also provides a useful baseline for individuals without any cognitive symptoms.
Screening for cognitive impairment in human immunode. Hiv dementia has an annual incidence of 7% after aids development and eventually affects 20% of all hiv infected persons. This tool provides a rapid assessment of eye movements, motor skills, simple learning, and attention. Antiretroviral therapy can not only prevent, but also reduce the severity of symptoms in people who have it already.
Validity of the international hiv dementia scale in brazil. It is most often seen in advanced stages of the disease. This test is similar to the hiv dementia scale, but was revised to replace writing the alphabet and cube drawing tests with more universal motor and psychomotor tasks, to translate more directly across cultures and literacy. People with hiv and aids sometimes develop cognitive impairment, particularly in the later stages of their illness. Dementia and general cognitive decline are hallmarks of laterstage hiv infections, and collectively are known as aids dementia complex adc. This tool is not meant to be viewed by the patient during the test.
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