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Publication Abstract Display
Type: Published Manuscript
Title: Assessing cognitive functioning in people living with HIV (PLWH): Factor analytic results from CHARTER and NNTC cohorts.
Authors: May PE, Heithoff AJ, Wichman CS, Phatak VS, Moore DJ, Heaton RK, Fox HS
Year: 2020
Publication: Journal of Acquired Immune Deficiency Syndromes
Volume: 83 Issue: 3 Pages: 251-259
Abstract:Background: Single summary scores, such as the Global Deficit Score (GDS), are often used to classify overall performance on neuropsychological batteries. The factor structure of test scores that underlie GDS in studies of persons living with HIV (PLWH) was assessed to determine if individual test scores loaded onto a unitary factor to summarize performance. Setting: Secondary data analysis on baseline data of PLWH from National NeuroAIDS Tissue Consortium (NNTC) and CNS HIV Antiretroviral Therapy Effects Research (CHARTER) Study. Method: Primary analyses included testing model structure and fit of neuropsychological test scores with confirmatory and exploratory factor analyses (CFAs and EFAs). Secondary analyses involved receiver operating characteristic curves, and associations with psychosocial and medical variables. Results: Participants with confounds were excluded, leading to 798 (NNTC) and 1,222 (CHARTER) cases. When CFA models were structured to be consistent with theoretically-based cognitive domains, models did not fit adequately. Per EFAs, tests assessing speeded information processing, working memory, and executive functions loaded onto a single factor and explained the most variance in both cohorts. This factor tended to be associated with age, estimated premorbid ability, and aspects of substance use history. Its relation to age, in context of demographically-corrected neuropsychological scores, suggested accelerated aging. Conclusion: Results indicate that individual neuropsychological tests did not load exactly onto expected domains, suggesting another framework for future analyses of cognitive domains. The possibility of a new index, as well as its use to assess cognitive impairment in PLWH, is suggested for further diagnostic and prognostic purposes.

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