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BMC Neurology

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Open Access 01-12-2015 | Research article

Quantifying cognition at the bedside: a novel approach combining cognitive symptoms and signs in HIV

Authors: Marie-Josée Brouillette, Lesley K. Fellows, Lisa Palladini, Lois Finch, Réjean Thomas, Nancy E. Mayo

Published in: BMC Neurology | Issue 1/2015

Abstract

Background

Up to half of all people with HIV infection have some degree of cognitive impairment. This impairment is typically mild, but nonetheless often disabling. Although early detection of cognitive impairment offers the greatest hope of effective intervention, there are important barriers to this goal in most clinical settings. These include uncertainty about how self-reported cognitive symptoms relate to objective impairments, and the paucity of bedside measurement tools suitable for mild deficits. Clinicians need guidance in interpreting cognitive symptoms in this population, and a brief cognitive measurement tool targeted to mild impairment. We addressed these two problems together here. The objective of this study was to determine the extent to which performance on cognitive tests and self-reported cognitive symptoms form a unidimensional construct.

Methods

Two hundred three HIV+ individuals completed the Montreal Cognitive Assessment, computerized cognitive tasks and a questionnaire eliciting cognitive symptoms. Rasch measurement theory was applied to determine whether patient-reported and performance items could be combined to measure cognition as a unidimensional latent construct.

Results

Performance-based items and cognitive symptoms are arranged hierarchically along the same continuum of cognitive ability, forming a measure with thresholds covering a broad spectrum of ability that has good internal reliability. The cognitive symptoms that fit the measurement model relate to important aspects of everyday life, providing evidence that the identified construct is meaningful.

Conclusions

This finding lays the foundation for a rapid measure of cognitive ability in people with HIV infection that is feasible for routine clinical use, and shows that some cognitive symptoms are systematically related to performance in this population.

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Title: Quantifying cognition at the bedside: a novel approach combining cognitive symptoms and signs in HIV
Authors: Marie-Josée Brouillette
Lesley K. Fellows
Lisa Palladini
Lois Finch
Réjean Thomas
Nancy E. Mayo
Publication date: 01-12-2015
Publisher: BioMed Central
Published in: BMC Neurology / Issue 1/2015
Electronic ISSN: 1471-2377
DOI: https://doi.org/10.1186/s12883-015-0483-1

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Quantifying cognition at the bedside: a novel approach combining cognitive symptoms and signs in HIV

Abstract

Background

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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