Comparison of the Minimental State Examination Scale and the International HIV Dementia Scale in Assessing Cognitive Function in Nigerian HIV Patients on Antiretroviral Therapy

Abstract

Introduction. HIV-associated neurocognitive disorder (HAND) remains common despite the availability of antiretroviral therapy. Routine screening will improve early detections. Objective. To compare the performance of the minimental state examination (MMSE) and international HIV dementia scale (IHDS) in assessing neurocognitive function in HIV/AIDS patients on antiretroviral therapy. Methods. A case-control study of 208 HIV-positive and 121 HIV-negative individuals. Baseline demographic data were documented and cognitive function assessed using the two instruments. CD4 cell counts were recorded. Results. Cases comprised 137 females and 71 males. Controls were 86 females and 35 males. Mean MMSE score of cases was 27.7 ± 1.8 compared to 27.8 ± 1.3 in controls (P = 0.54). Mean IHDS score in cases was 8.36 ± 3.1 compared to 10.7 ± 0.9 in controls (P < 0.001). Using the MMSE scale, 6 cases but no controls had HAND (P = 0.09). Using the IHDS, 113 (54.3%) had HAND compared with 10 (8.3%) controls (P < 0.0001). Using IHDS, 56.5% cases with CD4 count > 200 had HAND compared with 92.5% with CD4 count < 200 (P < 0.001). Conclusion. These findings indicate that the IHDS detects higher rates of HAND and may identify HIV/AIDS patients who require further cognitive assessment using more robust assessment batteries.

Prevalence of HIV associated neurocognitive deficit among HIV positive people in Ethiopia: a cross sectional study at Ayder Referral Hospital

“…Yet, it is important to note that the high prevalence of neurocognitive deficit in this study may reflect the need for further refinement of the tool, IHDS, at national level. As compared to prior studies, the current finding is similar with the result of a study conducted in India (32.5%) (18), a study done in Nigeria (34.4%) [28] and an earlier Metaanalysis (systemic review) in Sub-Saharan area (30.9%) (2). However, it is less than the findings of previous studies undertaken in Botswana (38%) (21), a study in the international community (37%) (15), a study done in Cameroon (85%) [29], a study conducted in Asia (90%) (19) and a Ugandan study (46.49%) (30,31,32).…”

A Comparison of Five Brief Screening Tools for HIV-Associated Neurocognitive Disorders in the USA and South Africa

“…We have demonstrated that both the IHDS and CAT-rapid are useful in screening for HIV-D. We confirm, as others have, that the MMSE has relatively poor sensitivity [20, 30]. No single tool proved to be ideal in screening for symptomatic HAND, although the CAT-rapid displayed fair sensitivity (78 %) with only weak specificity (54 %), while the IHDS showed weak sensitivity (52 %) and good specificity (86 %).…”

Determinants of Neurocognitive Impairment in HIV in a Cohort of Patients on Antiretroviral Therapy Followed in Bangui (Central African Republic)

“…Among PLHIV with NCD, the average score was 9 and in the US cohort (9.3) as well as in the Ugandan cohort when it was 9.9 [11]. Our finding is similar to that reported in Nigeria (8.36) by Oshinaike Olajumoke et al [31], in Cameroon (9.4) by Njamnshi et al [27]. This argues for the universality of the use of IHDS.…”

“…But it is the IHDS is advised. Furthermore IHDS compared the MMSE (Mini Mental State Examination) detect much on the NCD HIV field [31]. Note that HIV-related dementia has an annual incidence of 7% after development of AIDS and ultimately affects 20% of people infected with HIV.…”