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|Publication Abstract Display|
|Title: Sensitivity of a performance-based assessment of functional impairment to HIV and neuropsychological status in Spanish-speakers.|
|Authors: Gupta S, Georges S, Hendrix TR, Sukarez P, Heaton RK, Cherner M, and the HNRC Group|
|Abstract:INTRO: HIV-associated neurocognitive diagnoses require assessment of neuropsychological impairment (NPI) and its functional impact in everyday life. However, development and validation of performance-based functional assessments lag, particularly for Spanish speakers.
METHODS: We sought to validate the use of a performance-based battery of instrumental activities of daily living in 98 HIV+ [age: m=40.8 (10.3); education: m=11.5 (3.9)] and 104 HIV- [age: m=39.8 (13.6); education: m=11.7 (4.2)] Spanish-speakers. The battery included 8 tasks requiring daily living skills. Task deficit scores and impairment cut-points were developed based on the HIV- distribution of scores. The deficit scores were averaged to produce an overall functional deficit score (FDS). NPI was classified using a Spanish language neuropsychological battery with demographically-corrected norms. We compared functional performance among HIV-, HIV+ without NPI (HIV+NPI-) and HIV+ with NPI (HIV+NPI+). The three groups did not differ significantly on age or education. Although the HIV- group had significantly more women (p<.001), gender was unrelated to functional or NPI.
RESULTS: Chi square analyses revealed significantly higher prevalence of functional impairment among HIV+NPI+ (39%) compared to HIV+NPI- (10.7%) and HIV- (12.5%; p < .01). We then selected the four functional tasks that best discriminated between groups and generated an abbreviated FDS-2, which proved more sensitive (56.5%, 21.3% and 16.4% functionally impaired, respectively; p<.001).
CONCLUSIONS: Findings support the utility of our battery in assessing the functional impact of HIV-associated NPI. The FDS-2 requires considerably less administration time and, pending cross validation, may prove to be a better indicator of functional decline in HIV.|
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