Cargando…

A High Prevalence Rate of a Positive Screen for Cognitive Impairment in Patients With Human Immunodeficiency Virus Attending an Irish Clinic

BACKGROUND: Human immunodeficiency virus (HIV)-associated neurocognitive disorders occurs in 20%–50% of HIV-positive patients. We undertook this study to assess the prevalence of a positive screen for cognitive impairment in the clinic population at our institution and to demonstrate the feasibility...

Descripción completa

Detalles Bibliográficos
Autores principales: McNamara, Patricia H., Coen, Robert, Redmond, Janice, Doherty, Colin P., Bergin, Colm
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5414021/
https://www.ncbi.nlm.nih.gov/pubmed/28480240
http://dx.doi.org/10.1093/ofid/ofw242
_version_ 1783233278648516608
author McNamara, Patricia H.
Coen, Robert
Redmond, Janice
Doherty, Colin P.
Bergin, Colm
author_facet McNamara, Patricia H.
Coen, Robert
Redmond, Janice
Doherty, Colin P.
Bergin, Colm
author_sort McNamara, Patricia H.
collection PubMed
description BACKGROUND: Human immunodeficiency virus (HIV)-associated neurocognitive disorders occurs in 20%–50% of HIV-positive patients. We undertook this study to assess the prevalence of a positive screen for cognitive impairment in the clinic population at our institution and to demonstrate the feasibility of implementing a screening program in routine clinical encounters. METHODS: This was a cross-sectional study, and patients were recruited prospectively between December 2010 and February 2013. Inclusion criteria were as follows: patients were HIV positive, over the age of 18, capable of giving informed consent, and had sufficient ability to communicate in English. Patients were screened for cognitive impairment using the Brief Neurocognitive Screen. RESULTS: A total of 604 patients were recruited, and 51.5% had a positive screen for cognitive impairment. The majority of the study cohort were male (78.8%), mean age was 40.9 (standard deviation, 10.2) years, 70.9% were Irish, the most common mode of transmission was men who have sex with men (49.3%), 83% were on antiretroviral therapy, and 88.7% were virally suppressed. Logistic regression showed that the main factors predictive of a positive screen for cognitive impairment were the endorsement of cognitive symptoms (P = .024), being born in Africa (P < .000001), the use of benzodiazepines (P = .00341), being unemployed (P = .008), and consumption of more than 40 units of alcohol weekly (P = .035). There was a positive screen for depression in 9.1% and a positive screen for anxiety in 24.5%. CONCLUSIONS: The study highlights the necessity for a structured, prospective, large-scale screening program for cognitive impairment across countries with limited resources and demonstrates the feasibility of easily implementing this with minimal training.
format Online
Article
Text
id pubmed-5414021
institution National Center for Biotechnology Information
language English
publishDate 2016
publisher Oxford University Press
record_format MEDLINE/PubMed
spelling pubmed-54140212017-05-05 A High Prevalence Rate of a Positive Screen for Cognitive Impairment in Patients With Human Immunodeficiency Virus Attending an Irish Clinic McNamara, Patricia H. Coen, Robert Redmond, Janice Doherty, Colin P. Bergin, Colm Open Forum Infect Dis Major Article BACKGROUND: Human immunodeficiency virus (HIV)-associated neurocognitive disorders occurs in 20%–50% of HIV-positive patients. We undertook this study to assess the prevalence of a positive screen for cognitive impairment in the clinic population at our institution and to demonstrate the feasibility of implementing a screening program in routine clinical encounters. METHODS: This was a cross-sectional study, and patients were recruited prospectively between December 2010 and February 2013. Inclusion criteria were as follows: patients were HIV positive, over the age of 18, capable of giving informed consent, and had sufficient ability to communicate in English. Patients were screened for cognitive impairment using the Brief Neurocognitive Screen. RESULTS: A total of 604 patients were recruited, and 51.5% had a positive screen for cognitive impairment. The majority of the study cohort were male (78.8%), mean age was 40.9 (standard deviation, 10.2) years, 70.9% were Irish, the most common mode of transmission was men who have sex with men (49.3%), 83% were on antiretroviral therapy, and 88.7% were virally suppressed. Logistic regression showed that the main factors predictive of a positive screen for cognitive impairment were the endorsement of cognitive symptoms (P = .024), being born in Africa (P < .000001), the use of benzodiazepines (P = .00341), being unemployed (P = .008), and consumption of more than 40 units of alcohol weekly (P = .035). There was a positive screen for depression in 9.1% and a positive screen for anxiety in 24.5%. CONCLUSIONS: The study highlights the necessity for a structured, prospective, large-scale screening program for cognitive impairment across countries with limited resources and demonstrates the feasibility of easily implementing this with minimal training. Oxford University Press 2016-12-27 /pmc/articles/PMC5414021/ /pubmed/28480240 http://dx.doi.org/10.1093/ofid/ofw242 Text en © The Author 2016. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. http://creativecommons.org/licenses/by/4.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Major Article
McNamara, Patricia H.
Coen, Robert
Redmond, Janice
Doherty, Colin P.
Bergin, Colm
A High Prevalence Rate of a Positive Screen for Cognitive Impairment in Patients With Human Immunodeficiency Virus Attending an Irish Clinic
title A High Prevalence Rate of a Positive Screen for Cognitive Impairment in Patients With Human Immunodeficiency Virus Attending an Irish Clinic
title_full A High Prevalence Rate of a Positive Screen for Cognitive Impairment in Patients With Human Immunodeficiency Virus Attending an Irish Clinic
title_fullStr A High Prevalence Rate of a Positive Screen for Cognitive Impairment in Patients With Human Immunodeficiency Virus Attending an Irish Clinic
title_full_unstemmed A High Prevalence Rate of a Positive Screen for Cognitive Impairment in Patients With Human Immunodeficiency Virus Attending an Irish Clinic
title_short A High Prevalence Rate of a Positive Screen for Cognitive Impairment in Patients With Human Immunodeficiency Virus Attending an Irish Clinic
title_sort high prevalence rate of a positive screen for cognitive impairment in patients with human immunodeficiency virus attending an irish clinic
topic Major Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5414021/
https://www.ncbi.nlm.nih.gov/pubmed/28480240
http://dx.doi.org/10.1093/ofid/ofw242
work_keys_str_mv AT mcnamarapatriciah ahighprevalencerateofapositivescreenforcognitiveimpairmentinpatientswithhumanimmunodeficiencyvirusattendinganirishclinic
AT coenrobert ahighprevalencerateofapositivescreenforcognitiveimpairmentinpatientswithhumanimmunodeficiencyvirusattendinganirishclinic
AT redmondjanice ahighprevalencerateofapositivescreenforcognitiveimpairmentinpatientswithhumanimmunodeficiencyvirusattendinganirishclinic
AT dohertycolinp ahighprevalencerateofapositivescreenforcognitiveimpairmentinpatientswithhumanimmunodeficiencyvirusattendinganirishclinic
AT bergincolm ahighprevalencerateofapositivescreenforcognitiveimpairmentinpatientswithhumanimmunodeficiencyvirusattendinganirishclinic
AT mcnamarapatriciah highprevalencerateofapositivescreenforcognitiveimpairmentinpatientswithhumanimmunodeficiencyvirusattendinganirishclinic
AT coenrobert highprevalencerateofapositivescreenforcognitiveimpairmentinpatientswithhumanimmunodeficiencyvirusattendinganirishclinic
AT redmondjanice highprevalencerateofapositivescreenforcognitiveimpairmentinpatientswithhumanimmunodeficiencyvirusattendinganirishclinic
AT dohertycolinp highprevalencerateofapositivescreenforcognitiveimpairmentinpatientswithhumanimmunodeficiencyvirusattendinganirishclinic
AT bergincolm highprevalencerateofapositivescreenforcognitiveimpairmentinpatientswithhumanimmunodeficiencyvirusattendinganirishclinic