Abstract

Objective: To determine whether the recommended cutoffs for the Montreal Cognitive Assessment (MoCA), Modified HIV Dementia Scale (MHDS), and International HIV Dementia Scale (IHDS) are appropriate for screening for HAND in patients with HIV. Method: Inclusion criteria were age 18–64, diagnosed with HIV in the past year, and CD4 count ≥ 350. Fifty percent were male and 94% were African American. Of the 187 HIV+ patients included, descriptive statistics were mean (SD): 32.0 (11.1) years of age, 11.6 (2.2) years of education, 2.3 (2.8) months with HIV diagnosis, 582.3 (208.9) CD4 count, 80.4 (13.6) Wide Range Achievement Test (WRAT) standard score, 21.5 (4.6) MoCA score, 8.6 (2.8) MHDS score, and 9.8 (1.8) IHDS score. Results: Overall, 28.3%, 59.3%, and 83.8% of patients obtained scores below the recommended cutoffs for the MHDS (< 24 for the MoCA;1 however, 59.5% of the sample obtained scores below this score). The MHDS and MoCA were correlated with WRAT4 scores (.69 and .72) and years of education (.34 and .42) but not months diagnosed (.004 and .10) or CD4 count (−0.03 and .04). The IHDS was correlated with WRAT4 scores (.41) but not years of education (.18), months diagnosed (.004), or CD4 count (-03). Conclusion(s): These screeners have a tremendous false positive rate in this socioeconomically disadvantaged population. Future research should include follow-up with comprehensive test batteries to determine whether these measures are assessing neuropsychological problems other than HAND and poor literacy.