Combining Measures May Improve Detection of Poor Neurocognition in HIV

Combining frailty measures may the improve detection of HIV-associated neurocognitive disorders (HAND), according to findings published in AIDS. David Moore, PhD, and colleagues assessed the best measure for predicting HAND in 284 people with HIV aged 50 and older. Frailty measurements included the Fried Phenotype, the Rockwood Frailty Index, and the Veterans Aging Cohort Study (VACS) Index. Across all measures, frailty was higher in HIV-associated dementia (HAD) compared with no HAND. For the Fried and Rockwood measures, frailty was significantly more severe in mild neurocognitive disorder (MND) versus no HAND and in HAD versus asymptomatic neurocognitive impairment. In discriminating symptomatic HAND from no HAND, Fried was 37% sensitive and 92% specific, Rockwood was 85% sensitive and 43% specific, and VACS was 58% sensitive and 65% specific. The Fried and Rockwood measures outperform VACS in predicting HAND. However, no measure had adequate predictive validity in detecting HAND, indicating that “combined use of the Rockwood and Fried indices may be an appropriate alternative,” Dr. Moore and colleagues wrote.