| Publication Abstract Display | | Type: Published Abstract | | Title: The utility and limitations of the HIV Dementia Scale. | | Authors: Childers M, Ellis R, Deutsch R, Wolfson T, Grant I, and the HNRC Group | | Year: 2002 | | Publication: Journal of the International Neuropsychological Society | | Volume: 8 Issue: 2 Pages: 160 | | Abstract:Background: The HIV Dementia Scale (HDS) is a brief instrument designed
to identify HIV-associated cognitive impairment. Objectives: Weassessed the scale’s utility by comparing HDS scores to global impairment
ratings derived from a comprehensive neuropsychological (NP) test battery.
Methods: Subjects were 164 HIV-seropositive men and 40 women
enrolled in a prospective, longitudinal research study. Each completed the
HDS and a comprehensive battery of standardized neuropsychological
tests. Demographically-corrected NP test scores were used to assign a
clinical global NP rating of impaired or not impaired, against which
HDS scores were evaluated. In using an HDS cutoff score to identify
impaired subjects, sensitivity was judged to be more important than specificity
(i.e., a high proportion of HDS-impaired subjects would be impaired
based on global NP ratings). For identifying unimpaired subjects,
specificity was judged to be more important (i.e., a high proportion of
HDS-unimpaired subjects would be unimpaired on global NP ratings).
Results: HDS scores below 11 demonstrated 97% sensitivity and 32%
specificity in identifying subjects with global NP impairment. HDS scores
above 15 showed 61% sensitivity and 81% specificity in identifying those
without NP impairment. Scores equal to and between 11 and 15 (44% of
subjects) were indeterminate. HDS scores were significantly related to
education and ethnicity. Conclusions: Given the caveats noted above, the
HDS may be used to quickly confirm impairment status when the clinician
reasonably suspects impairment or nonimpairment, and patients are unable
to complete more extensive neuropsychological testing. |
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