Hiv dementia has an annual incidence of 7% after aids development and eventually affects 20% of all hiv infected persons. Dementia is chronic, global, usually irreversible deterioration of cognition. Most people dont know that hiv actually makes its way to the brain early in the disease process. Hiv and dementia health encyclopedia university of. The mmse and hds screening tests require individuals to perform tasks that test cognitive functions of memory, attention and fine motor function. Global deterioration scale alzheimer society of canada. Conversely, lack of early diagnosis might delay appropriate interventions such as antiretroviral therapy modifications.
This study aimed to examine the classification accuracy of the hds using raw and normbased cut points and to evaluat. Total scores range from 0 to 10 based on a scale of 0 to 2 for five items, with a higher score indicating more severe pain 0no pain. Jan 01, 20 the hiv dementia scale hds was developed to screen for hiv associated neurocognitive disorders hand, but concerns have persisted regarding its substandard sensitivity. Barar2 1assistant professor, department of pharmacology, sardar patel medical college, bikaner, rajasthan, india. Patient health questionnaire2 phq2 mental disorders. The international hiv dementia scale ihds is a crosscultural screening test to detect hiv dementia. The mcsi was modified and developed in 2003 with a sample of 158 family caregivers providing assistance to older adults living in a communitybased.
This scale divides alzheimers disease into seven stages of ability. This study aimed to examine the classification accuracy of the hds using raw and normbased cutpoints, and to evaluate the contribution of the hds subtests to predicting hand. The stages of alzheimers disease as defined by fast are. Limitations of the international hiv dementia scale in the. Hiv dementia scale hds and its modified form for use in international settings i. Hiv infection is increasing in minority groups, particularly in african american and hispanic women. This curve depicts a significant roc model screening for had at a cutoff score of 10. This tool provides a rapid assessment of eye movements, motor skills, simple learning, and attention. Assessment, diagnosis, and treatment of hivassociated. We aimed to develop a simpler version of the hdsthe modified hds mhds which would be appropriate for use by nonneurologists. The global deterioration scale for assessment of primary degenerative dementia the global deterioration scale gds, developed by dr. Hierarchic dementia rating scale hdr available in source book of geriatric assessment by liliane israel must be purchased cerad the consortium to establish a registry for alzheimers disease diagnostic criteria for alzheimers disease. Since the start of the aids epidemic more than two decades ago, doctors, caregivers and patients themselves have observed that some people with the disease experience declines in brain function and movement skills as well as slight or sudden shifts in behavior and mood.
Modified hiv dementia scale versus the grooved pegboard. Hivinfected patients were evaluated using the international hivdementia scale. Consensus was defined as at least 75% of participants scoring within the 79. Repeat words if the patient does not recall them all immediately. The hiv dementia scale hds previously has been shown to be sensitive in identifying persons with hivassociated dementia had. Hiv associated neurocognitive disorder hand remains a frequent problem despite effective antiretroviral therapy. This was a case control study involving 351 hiv cases and 150 hiv negative controls. Global deterioration scale some healthcare professionals use the global deterioration scale, also called the reisberg scale, to measure the progression of alzheimers disease.
The hiv dementia scale hds and international hiv dementia scale ihds are brief tools that have been developed to screen for and aid diagnosis of hivassociated dementia had. The feasibility, reliability, and clinical utility of the agitated behavior scale in braininjured rehabilitation patients. Diagnostic accuracy of the international hiv dementia scale and hiv. Sir, read with interest an article entitled assessment of neurocognitive functions in hivaids patients on haart using international hiv. It is most common in people who are not on effective hiv medications and when the cd4 cell count is very low. Pdf usefulness of the hiv dementia scale in nigerian. The efficiencies of each instrument for identifying hiv dementia were as follows. In the prehaart era, the hiv dementia scale hds was developed and subsequently modified for use in international settings as the international hiv dementia scale ihds. The selfassessment questionnaire had low sensitivity and might not be useful as a. Diagnostic accuracy of the international hiv dementia scale and.
They are increasingly being used in clinical practice for minor neurocognitive disorder mnd as well as had, despite uncertainty about their accuracy. Dementia describes a syndrome involving impairments in thinking, behaviour and the ability to perform everyday tasks. Although the incidence of hiv dementia has decreased since the advent of highly active antiretroviral treatment, prevalence of neurocognitive complications has increased as patients are now living longer. The hds focuses on four major areas of neurological functioning. The modified hiv dementia scale mhds is a fast, reliable measure of hiv associated dementia.
To access the international hiv dementia scale, refer to mental health screening tools. Cornell scale for depression in dementia csdd pdf see page 8. Validity of the international hiv dementia scale in brazil scielo. It offers a brief assessment of the persons attention, concentration, orientation to. Vascular dementia as a result of infarction of the brain due to vascular disease, including hypertensive cerebrovascular disease. Pdf validity of the international hiv dementia scale in. Validity of the international hiv dementia scale in brazil. The objective of this study was to compare the hiv dementia scale hds with comprehensive neuropsychological procedures in detecting both minor cognitive and motor disorder mcmd and hiv d in a population of patients with varying durations of haart. Use of international hiv dementia scale in assessment of. The ihds is a modification of the hiv dementia scale first proposed by power et al.
The hiv dementia scale hds was developed to screen for hiv associated neurocognitive disorders hand, but concerns have persisted regarding its substandard sensitivity. Utility of the hiv dementia scale hds in identifying hiv. The results show that this scale is a useful and valid diagnostic screening test for hiv associated neurocognitive. Diagnostic accuracy of the international hiv dementia. The international hiv dementia scale ihds was developed as a tool to detect hiv dementia in both industrialized and resourcelimited settings. Resources for care providers aids institute clinical. We aimed to develop a simpler version of the hdsthe modified hds mhdswhich would be appropriate for use by nonneurologists. The 3ms was intended to improve discrimination among different levels of dementia.
It is quick and does not require a neurologist to administer it. The performance of international hiv dementia scale ihds. The national hiv curriculum is an aids education and training center aetc program supported by the health resources and services administration hrsa of the u. We therefore tested influence of hiv serostatus and education on a commonly used tool to screen for cognitive impairment, the international hiv dementia scale ihds, among indian men and women in the catchment area of the post graduate institute of medical education and research pgimer located in chandigarh, india. Studies employing the ihds have produced mixed results, with recent data suggesting unusually high rates of dementia among ugandans. Older age and hivassociated neurocognitive disorder hand. Screening for cognitive impairment in human immunodeficiency virus. The modified caregiver strain index mcsi is a more recent version of the caregiver strain index csi developed in 1983. Hiv encephalopathy is caused by hiv spreading in the brain and harming it.
The ihds was originally validated in both a us and subsaharan african population from uganda. Concurrent classification accuracy of the hiv dementia. Diagnostic utility of the international hiv dementia scale. Risk factors for neurocognitive impairment in hivinfected patients. The mmse is an intervieweradministered questionnaire testing 5 domains orientation, memory registration, attention and.
The international hiv dementia scale is a validated brief screening instrument that can be administered by nonneurologists and may detect early motor and cognitive slowing. The hiv dementia scale hds previously has been shown to be sensitive in identifying persons with hiv associated dementia had. Sixtysix hiv positive individuals in the us and 81 hiv positive individuals in uganda received the ihds and full standardized neurological and. Aug 14, 2012 this aim of this study was to assess the diagnostic accuracy of the international hiv dementia scale ihds or hiv dementia scale hds for the diagnosis of hiv associated neurocognitive disorders hand. The value of the hiv dementia scale in vascular mild cognitive impairment, alzheimers and dementia on deepdyve, the largest online rental service for scholarly research with thousands of academic publications available at your fingertips. Functional assessment staging test the functional assessment staging test fast is the most well validated measure of the course of ad in the published, scientific literature. About depression and alzheimers disease fact sheet. To compare the performance of international hiv dementia scale ihds and mini mental status examination mmse scale in assessing hiv associated neurocognitive disorders. Additionally, hiv may facilitate the development of degenerative brain diseases associated with ageing, including alzheimers disease and parkinsons disease. The hds includes subtests that evaluate motor speed timed written alphabet, memory recall of four words at 5 min, constructional praxis cube copy time, and executive functions antisaccadic errors subtest.
Although the specific symptoms vary from person to person, they may be part of a single disorder known as aids dementia. This is an app version of the hiv dementia scale, developed by the johns hopkins hiv neurosciences group as a simple screening tool for hiv associated neurocognitive disorders hand. Hiv can invade the brain and cause a variety of symptoms. Accurate and early diagnosis of hiv dementia can lead to optimized therapeutic and management decisions. Education effects on the international hiv dementia scale. The hiv motor scale hms is a validated tool that captures motor abnormalities on routine neurologic examination and which is associated with cognitive impairment in. A casecontrol study of 208 hivpositive and 121 hivnegative individuals. For full access to this pdf, sign in to an existing account, or purchase an annual subscription. Background the hiv dementia scale hds and international hiv dementia scale ihds are brief tools that have been developed to screen for and aid diagnosis of hiv associated dementia had. Then ask the patient all four words after you have said them. The diagnostic utility of the international hiv dementia scale was analyzed using a receiver operating characteristic model. About dementia hiv associated dementia this help sheet describes hiv associated dementia and related conditions, their causes, symptoms, diagnosis and treatment.
Assessment of sleep and appetite sleep and appetite are important elements of a mental health assessment. Revalidation of the van rie hivaidsrelated stigma scale. Barry reisberg, provides caregivers an overview of the stages of cognitive function for those suffering from a primary degenerative dementia such as alzheimers disease. The term aids dementia complex was introduced by navia and. It was initially tested on hiv patients from the usa and uganda, with reported sensitivity and specificity of 80 and 55%, respectively 1. The provider should use it as a guide and demonstrate all actions to the patient with their own hands. Research suggests that cognitive performance in those with hiv is, on average, equivalent to that of people 10 years older without hiv. Human immunodeficiency hiv virus is usually among other disorders associated with cognitive impairment and dementia adding to the burden of the disease in affected individuals and the quality of care. International hiv dementia scale ihds memoryregistration. Hiv associated dementia is chronic cognitive deterioration due to brain infection by hiv. Assessing for hivassociated neurocognitive disorder hand is important and a twotiered approach first assessing symptoms with followup testing as needed is a reasonable paradigm to follow for busy practices. Aids dementia complex is caused by the hiv virus itself, not by the opportunistic infections that occur commonly in advanced hiv.
Two crosssectional cohort studies designed to evaluate for the presence of hiv dementia. Xls more info guidelines for managing alzheimers disease. The ideal screening tool should emphasize motor skills and timed tasks, must be inexpensive, universally available, brief, sensitive and reliable. The modified minimental state test evelyn teng, 1987 purpose the modified minimental state mmms, or 3ms test extends the scope of the minimental state examination mmse. The global deterioration scale for assessment of primary.
The test also provides a useful baseline for individuals without any cognitive symptoms. Kipp am, audet cm, earnshaw va, owens j, mcgowan cc, wallston ka 2015 revalidation of the van rie hivaids related stigma scale for use with people living with hiv in the united states. Hivassociated neurocognitive disorder hand answers are found in the johns hopkins hiv guide powered by unbound medicine. Background the hiv dementia scale hds and international hiv dementia scale.
Comparison of the minimental state examination scale and the. Screening for cognitive impairment in human immunodeficiency virus victor valcour. Psychiatric rating scales for alzheimers disease and dementia. People with alzheimers disease are particularly prone to depression. We do not know exactly how the virus damages brain cells. Of these tests, the hiv dementia scale hds developed by power et al.
Give 4 words to recall dog, hat, bean, red 1 second to say each. Scale subscale raw score agecorrected moans scaled score amss age and educationcorrected moans scaled score aemss %ile range attention 29 4 2 initiationperseveration 25 3 1 construction 6 10 41 59 conceptualization 35 8 19 28 memory 17 3 1 drs2 total score 112 2 1 note. A comprehensive and systematic search was carried out in pubmed and embase databases. The hds is a reliable and quantitative scale that is superior to other widely used bedside tests such as the mmse for identifying hiv dementia. These recommendations were developed by a panel of research and clinical experts using a modified delphi process. Screening for cognitive impairment in human immunode. Hivassociated neurocognitive disorder hand johns hopkins. Cognitive impairmentdementia in hiv patients in a faith.
Hiv dementia screening tools the most commonly referenced hiv screening tool is the hiv dementia scale hds 18. Pain assessment in advanced dementia painad scale fiveitem observational tool see the description of each item below. Xls more info ninds airen criteria for the diagnosis of vascular dementia cornell scale for. The hiv dementia scale hds and international hiv dementia scale ihds. See also overview of delirium and dementia and dementia. Score international hiv dementia scale ihds here is a short summary about the tool explaining in brief its efficacy. Because the basal ganglia are affected, hiv associated cognitive disorders including dementia share many features with diseases such as parkinsons disease and huntington disease. Cognitive dysfunction in human immunodeficiency virus hiv has decreased, but milder forms of hiv associated neurocognitive disorders hand persist along with motor dysfunction. Hiv aids affects many of the bodys organ systems, including the brain and nervous system. Hiv ds dementia scale hiv ds dementia scale this is an app version of the hiv dementia scale, developed by the johns hopkins hiv neurosciences group as a simple screening tool for hiv associated neurocognitive disorders hand. Alzheimers disease knowledge scale adks evidencereference. This tool is not meant to be viewed by the patient during the test. Diagnostic accuracy of the international hiv dementia scale. Study to compare performance of international hiv dementia scale ihds and hindi mental state examination hmse scale in assessing neurocognitive dysfunction among hiv aids patients on antiretroviral therapy savita saini1, kiran v.
Hiv associated dementia aids dementia complex may occur in the late. International hiv dementia scale ihds mental disorders. Study to compare performance of international hiv dementia. The purpose of the present study was to establish the validity of the hds in identifying hiv dementia in infected south africans, where the prevalence of hiv dementia is largely unknown. This aim of this study was to assess the diagnostic accuracy of the international hiv dementia scale ihds or hiv dementia scale hds for the diagnosis of hiv associated neurocognitive disorders hand. Is the modified hiv dementia scale a good screening tool for a nonneurologists the hop dear dr horwath i am a medical researcher at csir looking and cognition and depression in hiv.
The most severe form of impairment is hivassociated dementia had, requiring. International hiv dementia scale from sacktor 2003memoryregistration give four words to recall dog, hat, bean, red translated into the local language in luganda. Up to 50% of hiv patients will exhibit hand upon neuropsychological np testing. Alzheimers disease knowledge scale adks evidencereference list item reference 1. Hiv dementia is a subcortical dementia gabrieli, 1995, affecting structure beneath the cerebral cortex. The implication of these findings is that clinicians should have reasonable index of suspicion when managing patients that are hiv seropositive to be able to identify patients with cognitive problems. Characteristics of motor dysfunction in longstanding human. The hiv dementia scale with a modified cutoff of 14 points as. Stage stage name characteristic expected untreated ad duration months mental age years mmse score. Validity of the international hiv dementia scale in south africa article pdf available in aids patient care and stds 252.
Concurrent classification accuracy of the hiv dementia scale. The hds performance characteristics are modest with acceptable sensitivity only for the most severe disease. The clinician interviews the residents caregiver on each of the 19 items of the scale. Spanish validation of the hiv dementia scale in women. Cornell scale for depression in dementia the scale is designed as a screening tool and is not diagnostic 2 steps. The hiv dementia scale hds was developed to screen for had and later the international hds ihds was developed for use in global. Sometimes this disease is called hiv encephalopathy or aids dementia when the symptoms are severe. A crosssectional descriptive study was carried out in a nongovernmental organization caring for patients with the disease in jos, north central nigeria. Evaluation of brief screening tools for neurocognitive impai. The scale registers changes in managing daily activities such as deterioration of faculties misplacing, forgetting, loss of cognition for people, and loss of bodily and toilet functions. The study hypothesis was that there is a significant difference in the detection of hand when mmse is used compared to the ihds scale. Score hiv dementia scale hds previously has been shown to be sensitive in identifying persons with hiv associated dementia had. However, literacy may influence the psychomotor speed subscale mhdsps. We aimed to develop a simpler version of the hdsthe modified hds.
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