Age, cognitive status, and accuracy of ADL self-reports in adults living with HIV

ABSTRACT

Determination of functional capacity in cognitively impaired persons living with HIV (PLHIV) is pivotal to the accurate diagnosis of HIV-associated neurocognitive disorders (HAND). Functional data is typically collected through self-report. Reliability concerns arise with memory and executive functioning impairments, which could compromise the integrity of self-report and result in inaccurate HAND diagnoses. The current study tested the accuracy of older PLHIV functional reports through examination of concordance rates between self-report and caregiver’s (CG) report. Cross-sectional cognitive, mood, and functional status data were sampled from the Manhattan HIV Brain Bank. Participants and caregivers independently completed an Activities of Daily Living (ADL) questionnaire, producing 78 participant-caregiver dyads. Functional report concordance was operationalized by calculating differences between participant and CG ADL total scores. Assessment pairs differing by 2 or more points were considered to be discordant. Analyses revealed that one-third of the patient sample was discordant in the ADL report. ANOVA revealed that PLHIV overestimating their functional impairments, were significantly older, more educated, and more depressed than other participants. Global cognitive functioning was not associated with concordance. Thus, the majority of PLHIV were consistent with their caregivers’ ADL report, and older age and increased depressive symptomatology, but not cognitive status, were factors associated with discordance.

KEYWORDS:

• Caregiving
• functional status
• HIV
• PLHIV
• activities of daily living

Acknowledgements

The authors would like to thank the Manhattan HIV Brain Bank (MHBB); Dr. Jairo Gonzalez, Letty Mintz, Cira Carrion Park, Maria Pizzirusso, Rhonda Burgess, Kaitlyn Greenwood, and Elizabeth Tell for their support during this project and our amazing participants.

Disclosure statement

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

Additional information

Funding

This research study was supported by the National Institutes of Health [The Manhattan HIV Brain Bank, U24MH100931] and the National Center for Advancing Translational Sciences [U01MH083501].