Selection of cognitive impairment screening tools for longitudinal implementation in an HIV clinical care setting

ABSTRACT

To address and slow the increasing burden of cognitive impairment in people surviving to older ages with HIV requires longitudinal monitoring of cognition. We conducted a structured literature review to identify peer-reviewed studies employing validated cognitive impairment screening tools in adult populations of people with HIV. We identified three key criteria for selection and ranking of a tool: (a) strength of validity of the tool; (b) acceptability and feasibility of the tool; (c) ownership of the data from the assessment. From our structured review of 105, 29 studies met our inclusion criteria, within which 10 cognitive impairment screening measurement tools were validated in a population of people with HIV. The BRACE, NeuroScreen and NCAD tools were ranked highly when compared with the other seven tools. Additionally, patient population and clinical setting characteristics (such as availability of quiet space, timing of assessment, security of electronic resources, and ease of linkage to electronic health records) were included in our framework for selection of tools. Numerous validated cognitive impairment screening tools are available to monitor for cognitive changes in the HIV clinical care setting, detecting opportunities for earlier intervention to reduce cognitive decline and preserve quality of life.

KEYWORDS:

• HIV
• cognitive impairment
• screening

Acknowledgements

1. North American AIDS Cohort Collaboration on Research and Design (na-accord.org).

2. Central Nervous System Dysfunction Working Group (P30AI094189; Rubin).

3. Johns Hopkins Center for the Advacement of HIV Neurotherapeutics (JH CAHN; P30MH075773; Haughey, Rubin, Slusher).

KNA serves on the scientific advisory board for TrioHealth and is a consultant to the All of Us Research Program. LHR is a consultant for Digital Artefacts.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This work was supported by the Center for AIDS Research, Johns Hopkins University (Johns Hopkins HIV Clinical Cohort Grant): [Grant numbers U01DA036935, P30AI094189]; National Institutes of Health [U01AI069918].