More than two HANDs to tango

Dennis Kolson, Shilpa J Buch

Research output: Contribution to journalComment/debate

3 Citations (Scopus)

Abstract

Developing a validated tool for the rapid and efficient assessment of cognitive functioning in HIV-infected patients in a typical outpatient clinical setting has been an unmet goal of HIV research since the recognition of the syndrome of HIV-associated dementia (HAD) nearly 20 years ago. In this issue of JNIP Cross et al. report the application of the International HIV Dementia Scale (IHDS) in a U.S.-based urban outpatient clinic to evaluate its utility as a substitute for the more time- and effort-demanding formalized testing criteria known as the Frascati criteria that was developed in 2007 to define the syndrome of HIV-associated neurocognitive disorders (HAND). In this study an unselected cohort of 507 individuals (68 % African American) that were assessed using the IHDS in a cross-sectional study revealed a 41 % prevalence of cognitive impairment (labeled 'symptomatic HAND') that was associated with African American race, older age, unemployment, education level, and depression. While the associations between cognitive impairment and older age, education, unemployment status and depression in HIV-infected patients are not surprising, the association with African American ancestry and cognitive impairment in the setting of HIV infection is a novel finding of this study. This commentary discusses several important issues raised by the study, including the pitfalls of assessing cognitive functioning with rapid screening tools, cognitive testing criteria, normative testing control groups, accounting for HAND co-morbidity factors, considerations for clinical trials assessing HAND, and selective population vulnerability to HAND.

Original languageEnglish (US)
Pages (from-to)1051-1054
Number of pages4
JournalJournal of Neuroimmune Pharmacology
Volume8
Issue number5
DOIs
StatePublished - Dec 1 2013

Fingerprint

HIV
AIDS Dementia Complex
African Americans
Unemployment
Depression
Education
Ambulatory Care Facilities
HIV Infections
Cohort Studies
Outpatients
Cross-Sectional Studies
Neurocognitive Disorders
Clinical Trials
Morbidity
Control Groups
Research
Population
Cognitive Dysfunction

Keywords

  • Frascati criteria
  • HAND
  • HIV
  • HIV associated neurocognitive disorders
  • International HIV Dementia Scale
  • Neurocognitive dysfunction
  • Neuropsychological testing
  • Risk factors

ASJC Scopus subject areas

  • Neuroscience (miscellaneous)
  • Immunology and Allergy
  • Immunology
  • Pharmacology

Cite this

More than two HANDs to tango. / Kolson, Dennis; Buch, Shilpa J.

In: Journal of Neuroimmune Pharmacology, Vol. 8, No. 5, 01.12.2013, p. 1051-1054.

Research output: Contribution to journalComment/debate

Kolson, Dennis ; Buch, Shilpa J. / More than two HANDs to tango. In: Journal of Neuroimmune Pharmacology. 2013 ; Vol. 8, No. 5. pp. 1051-1054.
@article{d447779e886c45ce85b5d2aab377cb75,
title = "More than two HANDs to tango",
abstract = "Developing a validated tool for the rapid and efficient assessment of cognitive functioning in HIV-infected patients in a typical outpatient clinical setting has been an unmet goal of HIV research since the recognition of the syndrome of HIV-associated dementia (HAD) nearly 20 years ago. In this issue of JNIP Cross et al. report the application of the International HIV Dementia Scale (IHDS) in a U.S.-based urban outpatient clinic to evaluate its utility as a substitute for the more time- and effort-demanding formalized testing criteria known as the Frascati criteria that was developed in 2007 to define the syndrome of HIV-associated neurocognitive disorders (HAND). In this study an unselected cohort of 507 individuals (68 {\%} African American) that were assessed using the IHDS in a cross-sectional study revealed a 41 {\%} prevalence of cognitive impairment (labeled 'symptomatic HAND') that was associated with African American race, older age, unemployment, education level, and depression. While the associations between cognitive impairment and older age, education, unemployment status and depression in HIV-infected patients are not surprising, the association with African American ancestry and cognitive impairment in the setting of HIV infection is a novel finding of this study. This commentary discusses several important issues raised by the study, including the pitfalls of assessing cognitive functioning with rapid screening tools, cognitive testing criteria, normative testing control groups, accounting for HAND co-morbidity factors, considerations for clinical trials assessing HAND, and selective population vulnerability to HAND.",
keywords = "Frascati criteria, HAND, HIV, HIV associated neurocognitive disorders, International HIV Dementia Scale, Neurocognitive dysfunction, Neuropsychological testing, Risk factors",
author = "Dennis Kolson and Buch, {Shilpa J}",
year = "2013",
month = "12",
day = "1",
doi = "10.1007/s11481-013-9513-1",
language = "English (US)",
volume = "8",
pages = "1051--1054",
journal = "Journal of NeuroImmune Pharmacology",
issn = "1557-1890",
publisher = "Springer New York",
number = "5",

}

TY - JOUR

T1 - More than two HANDs to tango

AU - Kolson, Dennis

AU - Buch, Shilpa J

PY - 2013/12/1

Y1 - 2013/12/1

N2 - Developing a validated tool for the rapid and efficient assessment of cognitive functioning in HIV-infected patients in a typical outpatient clinical setting has been an unmet goal of HIV research since the recognition of the syndrome of HIV-associated dementia (HAD) nearly 20 years ago. In this issue of JNIP Cross et al. report the application of the International HIV Dementia Scale (IHDS) in a U.S.-based urban outpatient clinic to evaluate its utility as a substitute for the more time- and effort-demanding formalized testing criteria known as the Frascati criteria that was developed in 2007 to define the syndrome of HIV-associated neurocognitive disorders (HAND). In this study an unselected cohort of 507 individuals (68 % African American) that were assessed using the IHDS in a cross-sectional study revealed a 41 % prevalence of cognitive impairment (labeled 'symptomatic HAND') that was associated with African American race, older age, unemployment, education level, and depression. While the associations between cognitive impairment and older age, education, unemployment status and depression in HIV-infected patients are not surprising, the association with African American ancestry and cognitive impairment in the setting of HIV infection is a novel finding of this study. This commentary discusses several important issues raised by the study, including the pitfalls of assessing cognitive functioning with rapid screening tools, cognitive testing criteria, normative testing control groups, accounting for HAND co-morbidity factors, considerations for clinical trials assessing HAND, and selective population vulnerability to HAND.

AB - Developing a validated tool for the rapid and efficient assessment of cognitive functioning in HIV-infected patients in a typical outpatient clinical setting has been an unmet goal of HIV research since the recognition of the syndrome of HIV-associated dementia (HAD) nearly 20 years ago. In this issue of JNIP Cross et al. report the application of the International HIV Dementia Scale (IHDS) in a U.S.-based urban outpatient clinic to evaluate its utility as a substitute for the more time- and effort-demanding formalized testing criteria known as the Frascati criteria that was developed in 2007 to define the syndrome of HIV-associated neurocognitive disorders (HAND). In this study an unselected cohort of 507 individuals (68 % African American) that were assessed using the IHDS in a cross-sectional study revealed a 41 % prevalence of cognitive impairment (labeled 'symptomatic HAND') that was associated with African American race, older age, unemployment, education level, and depression. While the associations between cognitive impairment and older age, education, unemployment status and depression in HIV-infected patients are not surprising, the association with African American ancestry and cognitive impairment in the setting of HIV infection is a novel finding of this study. This commentary discusses several important issues raised by the study, including the pitfalls of assessing cognitive functioning with rapid screening tools, cognitive testing criteria, normative testing control groups, accounting for HAND co-morbidity factors, considerations for clinical trials assessing HAND, and selective population vulnerability to HAND.

KW - Frascati criteria

KW - HAND

KW - HIV

KW - HIV associated neurocognitive disorders

KW - International HIV Dementia Scale

KW - Neurocognitive dysfunction

KW - Neuropsychological testing

KW - Risk factors

UR - http://www.scopus.com/inward/record.url?scp=84891373194&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84891373194&partnerID=8YFLogxK

U2 - 10.1007/s11481-013-9513-1

DO - 10.1007/s11481-013-9513-1

M3 - Comment/debate

VL - 8

SP - 1051

EP - 1054

JO - Journal of NeuroImmune Pharmacology

JF - Journal of NeuroImmune Pharmacology

SN - 1557-1890

IS - 5

ER -