TY - JOUR
T1 - The University of California San Diego performance-based skills assessment: a useful tool to detect mild everyday functioning difficulties in HIV-infected patients with very good immunological condition
AU - Delle Donne, Valentina
AU - Ciccarelli, Nicoletta
AU - Massaroni, Valentina
AU - Borghetti, Alberto
AU - Dusina, Alex
AU - Farinacci, Damiano
AU - Visconti, Elena
AU - Tamburrini, Enrica
AU - Fabbiani, Massimiliano
AU - Di Giambenedetto, Simona
PY - 2020
Y1 - 2020
N2 - Everyday functioning (EF) impairment is frequent in people living with HIV (PLWH). Our aim was to better explore EF and its association with PLWH cognition, by administering both the IADL scale, the most common functional scale, and a new and ecologic multi-domain (communication and financial skills) tool to measure EF as the University of California San Diego (UCSD) Performance-Based Skills Assessment-Brief Version (UPSA-B). Eighty-five PLWH on cART with very good immunological condition and 23 age- and education-matched healthy controls (HC) were enrolled. PLWH underwent a standardized neuropsychological battery plus IADL, and cognitive impairment was defined according to Frascati criteria. Both groups underwent the UPSA-B. Only 6 subjects (7%) were affected by cognitive impairment (asymptomatic profile). While IADL score was at ceiling for all patients, the UPSA-B total score was significantly worse in PLWH when compared with HC [mean 82.1 (SD 9.3) vs 89.2 (SD 6.2); p < 0.001]. At communication subtest, PLWH group and HC were significantly different (p = 0.002), while no difference emerged at financial skills (p = 0.096). Higher score at UPSA-B was independently associated with better global cognitive performance (composite Z-score) (β 7.79; p < 0.001). Also considering each single cognitive domain, UPSA-B performance (both total and at subtests) confirmed the association with neurocognitive performance. In conclusion, UPSA-B seems to better discriminate EF impairment than IADL in PLWH, and it was associated with cognitive functions, also in the absence of symptomatic cognitive impairment. Thus, it appears a promising tool in the context of HIV infection to avoid misdiagnosis and to better detect also mild EF.
AB - Everyday functioning (EF) impairment is frequent in people living with HIV (PLWH). Our aim was to better explore EF and its association with PLWH cognition, by administering both the IADL scale, the most common functional scale, and a new and ecologic multi-domain (communication and financial skills) tool to measure EF as the University of California San Diego (UCSD) Performance-Based Skills Assessment-Brief Version (UPSA-B). Eighty-five PLWH on cART with very good immunological condition and 23 age- and education-matched healthy controls (HC) were enrolled. PLWH underwent a standardized neuropsychological battery plus IADL, and cognitive impairment was defined according to Frascati criteria. Both groups underwent the UPSA-B. Only 6 subjects (7%) were affected by cognitive impairment (asymptomatic profile). While IADL score was at ceiling for all patients, the UPSA-B total score was significantly worse in PLWH when compared with HC [mean 82.1 (SD 9.3) vs 89.2 (SD 6.2); p < 0.001]. At communication subtest, PLWH group and HC were significantly different (p = 0.002), while no difference emerged at financial skills (p = 0.096). Higher score at UPSA-B was independently associated with better global cognitive performance (composite Z-score) (β 7.79; p < 0.001). Also considering each single cognitive domain, UPSA-B performance (both total and at subtests) confirmed the association with neurocognitive performance. In conclusion, UPSA-B seems to better discriminate EF impairment than IADL in PLWH, and it was associated with cognitive functions, also in the absence of symptomatic cognitive impairment. Thus, it appears a promising tool in the context of HIV infection to avoid misdiagnosis and to better detect also mild EF.
KW - Activities of Daily Living
KW - Anti-HIV Agents
KW - Antiretroviral Therapy, Highly Active
KW - Attention
KW - CD4-Positive T-Lymphocytes
KW - Case-Control Studies
KW - Cognition
KW - Cognition evaluation
KW - Cognitive Dysfunction
KW - Everyday functioning
KW - Executive Function
KW - Female
KW - Functional assessment
KW - HIV Infections
KW - HIV-1
KW - HIV-associated neurocognitive disorders
KW - Humans
KW - Male
KW - Memory
KW - Middle Aged
KW - Neuropsychological Tests
KW - Psychiatric Status Rating Scales
KW - Psychomotor Performance
KW - Speech
KW - Activities of Daily Living
KW - Anti-HIV Agents
KW - Antiretroviral Therapy, Highly Active
KW - Attention
KW - CD4-Positive T-Lymphocytes
KW - Case-Control Studies
KW - Cognition
KW - Cognition evaluation
KW - Cognitive Dysfunction
KW - Everyday functioning
KW - Executive Function
KW - Female
KW - Functional assessment
KW - HIV Infections
KW - HIV-1
KW - HIV-associated neurocognitive disorders
KW - Humans
KW - Male
KW - Memory
KW - Middle Aged
KW - Neuropsychological Tests
KW - Psychiatric Status Rating Scales
KW - Psychomotor Performance
KW - Speech
UR - http://hdl.handle.net/10807/193328
U2 - 10.1007/s13365-020-00891-8
DO - 10.1007/s13365-020-00891-8
M3 - Article
SN - 1355-0284
VL - 26
SP - 899
EP - 907
JO - Journal of NeuroVirology
JF - Journal of NeuroVirology
ER -