Abstract

Objective: HIV-associated neurocognitive disorders (HAND), especially mild forms, are commonly observed among HIV-infected individuals. However, existing screening batteries, such as the HIV Dementia Scale and International HIV Dementia Scale, are not sensitive to mild neuropsychological (NP) impairment. HIV research and clinical care is in need of a brief NP screening battery that can quickly and accurately identify individuals who have HAND, especially milder versions. Method: Twenty-nine HIV-infected participants completed a seven-domain “gold standard” NP battery and the iPad-based NP screening. The iPad battery included seven tests assessing abilities previously shown to be particularly sensitive to HAND. All instructions were given both visually and auditorily. Global deficit scores (GDS), which give greater weight to impaired performance, were calculated based on the gold standard NP tests. Fifty-two percent of the participants were impaired. Results: Multivariate regression analyses found that four iPad tests (working memory, processing speed, executive function, and verbal learning) predicted impairments among HIV+ individuals (adjusted R2 = .59, p = .028). Using a stepwise multivariate regression approach, two iPad tests (processing speed and executive function) significantly predicted impairment (adjusted R2 = .29, p = .002). Conclusion(s): This preliminary study suggests that a brief battery using two to four measures may be sensitive to HAND. Future studies examining the iPad-based battery in a larger cohort and assessing its classification accuracy may be warranted. Given that participants could take this 10-minute battery independently, this iPad-based screening battery could be beneficial for busy HIV clinicians.