Screening Accuracy of Mini Addenbrooke’s Cognitive Examination Test for HIV-Associated Neurocognitive Disorders in People Ageing with HIV

Trunfio, Mattia; Francesco, Davide De; Vai, Daniela; Medina, Caterina; Milesi, Maurizio; Domini, Simone; Alcantarini, Chiara; Imperiale, Daniele; Bonora, Stefano; Perri, Giovanni Di; Calcagno, Andrea

doi:10.1007/s10461-021-03563-8

Cited by 5 publications

(5 citation statements)

References 61 publications

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“…The M-ACE demonstrated moderate diagnostic accuracy and good discriminatory power in distinguishing between individuals with CIND and Normal-cognition in LTC facilities, with an optimal cutpoint of 17 yielding a sensitivity of 81.7% and a specificity of 74.4%. These findings are consistent with previous studies validating the M-ACE in different populations, such as community-dwelling older adults (Charernboon, 2019;Kaczmarek et al, 2022;Qassem et al, 2021), and older individuals with HIV neurocognitive disorders (Trunfio et al, 2022). However, we observed a lower cut-off score compared to those previous studies, likely due to the older age, greater cognitive impairment, and functional disabilities of LTC residents.…”

Section: Discussionsupporting

confidence: 92%

“…Considering previous studies with subjects with MCI (Charernboon, 2019;Hobson et al, 2016;Kaczmarek et al, 2022;Larner, 2020;Lucza et al, 2018;Pan et al, 2022;Senda et al, 2020;Trunfio et al, 2022;Yang et al, 2019), an AUC between .77-.89 was considered a quality marker for the M-ACE classification performance. The M-ACE cut-off score with the highest Youden index (> .8 high, .4-.6 moderate level of separation) was used as the optimal cut-off (Fluss et al, 2005).…”

Section: Discussionmentioning

confidence: 99%

“…Although the M-ACE is widely used in various clinical and non-clinical settings to assess cognitive function (Hobson et al, 2016;Kaczmarek et al, 2022;Larner, 2019;Ridley et al, 2018;Senda et al, 2020;Trunfio et al, 2022), no research has been conducted on its validity among individuals in LTC settings.…”

Section: Introductionmentioning

confidence: 99%

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Mini-ACE: Validation Study Among Older People in Long-Term Care

Grasina,

Espirito-Santo,

Lemos

et al. 2024

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Background: The Mini-Addenbrooke’s Cognitive Examination (M-ACE) is a valid and reliable tool that accurately differentiates various types of cognitive impairment from Normal-cognition assessed in multiple settings. However, its validity among older individuals in long-term care (LTC) was not yet established. Therefore, we sought to assess the Portuguese M-ACE’s validity, reliability, and accuracy in detecting cognitive impairment no-dementia (CIND) in LTC users. Methods: A comprehensive assessment was performed on 196 LTC Portuguese users aged ≥ 60 years, among whom 71 had Normal-cognition, and 125 had CIND. Results: The M-ACE was found to be reliable (McDonald’s ω = .86, Cronbach’s α = .85) and consistent over time (r = .72; ICC = .83) and between raters (k = .92). Strong correlations with related measures supported construct validity (both r = .67). The M-ACE accurately distinguished CIND from Normal-cognition with a cut-off of 17 points (AUC = 0.81, Sensitivity = 81.7%, Specificity = 74.4%). Conclusion: Our findings suggest that the Portuguese M-ACE is a valid and reliable cognitive assessment tool for LTC users, allowing for accurate differentiation between CIND and Normal-cognition. Thus, the M-ACE’s use could contribute to the early detection and intervention of cognitive disorders, especially among older adults in LTC.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

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Mini-ACE: Validation Study Among Older People in Long-Term Care

Grasina,

Espirito-Santo,

Lemos

et al. 2024

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“…CNS disorders or infections, psychiatric conditions, language barriers, cerebrovascular events, substance use) completed a comprehensive battery of neurocognitive tests within 6 months from the lumbar puncture and serological assessment. Raw cognitive scores were converted into demographically corrected standard scores ( T scores) by referencing to normative standards for age, education, and sex, as previously detailed [23]. Eight cognitive domains were assessed by 15 tests: verbal/language, attention/working memory, abstraction/executive functions, memory, information processing speed, sensory–perceptual skills, and motor functioning.…”

Section: Methodsmentioning

confidence: 99%

Intrathecal production of anti-Epstein–Barr virus viral capsid antigen IgG is associated with neurocognition and tau proteins in people with HIV

Trunfio,

Sacchi,

Vai

et al. 2023

Aids

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Objective: HIV and EBV co-infection has been linked to increased immune activation and larger HIV reservoir. We assessed whether anti-EBV humoral responses are associated with increased cerebrospinal fluid (CSF) inflammation and with neurocognitive impairment (NCI) in people with HIV (PWH). Design: Cross-sectional analysis in 123 EBV-seropositive PWH either on antiretroviral therapy (n = 70) or not. Methods: Serum and CSF anti-EBV Viral Capsid Antigen Immunoglobulin G (anti-EVI) and CSF EBV DNA were measured by commercial immunoassay and RT-PCR. Seventy-eight participants without neurological confounding factors underwent neurocognitive assessment (Global Deficit Score, GDS). CSF total tau and 181-phosphorylated-tau (ptau) were measured by immunoassays together with biomarkers of blood-brain barrier (BBB) integrity, immune activation, astrocytosis, and intrathecal synthesis. Logistic and linear regressions and moderation analysis were used to investigate the relationships between CSF anti-EVI, GDS, and biomarkers. Results: Twenty-one (17.1%) and twenty-two participants (17.9%) had detectable CSF anti-EVI (10.5–416.0 U/mL) and CSF EBV DNA (25–971 cp/mL). After adjusting for BBB integrity, age, and clinical factors, the presence of CSF anti-EVI was only associated with serum levels of anti-EVI, and not with CSF EBV DNA. CSF anti-EVI and tau and ptau showed reciprocal interactions affecting their associations with GDS. After adjusting for demographics and clinical parameters, higher CSF anti-EVI levels were associated with worse GDS (aβ 0.45, p < 0.001), and CSF levels of tau and ptau had moderate the strength of this association (models’p < 0.001). Conclusions: Humoral immune responses against EBV within the central nervous system may contribute to NCI of PWH through mechanisms that involve neuronal injury.

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“…The primary target cells for HIV in the CNS are macrophages and microglia, which serve as reservoirs for viral replication. [ 19 ] HIV in the CNS triggers a cascade of events that ultimately contribute to neuronal dysfunction and cognitive impairment.…”

Section: Reviewmentioning

confidence: 99%

HIV-related neurocognitive disorders: Diagnosis, Treatment, and Mental Health Implications: A Review

Elendu,

Aguocha,

Okeke

et al. 2023

Medicine

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HIV-related neurocognitive disorders (HAND) have emerged as a significant concern in the context of HIV infection. This article provides a comprehensive overview of the diagnosis, treatment, and mental health implications associated with HAND. Diagnosis of HAND involves a multifaceted approach, combining clinical assessments, neurocognitive testing, and neuroimaging techniques. Various screening tools and standardized assessments have been developed to aid in the early detection and monitoring of HAND. Timely diagnosis allows for appropriate interventions and personalized treatment strategies. Treatment for HAND encompasses a multidisciplinary approach targeting different aspects of cognitive impairment. Antiretroviral therapy (ART) remains the cornerstone of treatment, effectively reducing viral load and preventing further neurocognitive decline. Adjunctive therapies, including cognitive rehabilitation, pharmacological interventions, and psychosocial support, play crucial roles in managing cognitive symptoms and enhancing overall quality of life. Mental health implications associated with HAND are profound and require special attention. Individuals with HAND are at higher risk of experiencing psychological distress, depression, anxiety, and reduced social functioning. Integrated care models that address physical and mental health aspects are vital in optimizing treatment outcomes and promoting mental well-being in this population. Furthermore, this paper highlights the need for ongoing research to unravel the underlying mechanisms of HAND and develop targeted interventions. Identifying risk factors, understanding the impact of HIV on the brain, and exploring novel treatment modalities are essential areas of focus. Additionally, living with HAND social and cultural aspects must be considered to ensure equitable access to care and support for all affected individuals.

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Screening Accuracy of Mini Addenbrooke’s Cognitive Examination Test for HIV-Associated Neurocognitive Disorders in People Ageing with HIV

Cited by 5 publications

References 61 publications

Mini-ACE: Validation Study Among Older People in Long-Term Care

Mini-ACE: Validation Study Among Older People in Long-Term Care

Intrathecal production of anti-Epstein–Barr virus viral capsid antigen IgG is associated with neurocognition and tau proteins in people with HIV

HIV-related neurocognitive disorders: Diagnosis, Treatment, and Mental Health Implications: A Review

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