The Repeatable Battery for the Assessment of Neuropsychological Status as a screening strategy for HIV-Associated Neurocognitive Disorders

AIDS Care. 2021 Mar;33(3):357-363. doi: 10.1080/09540121.2020.1742859. Epub 2020 Mar 17.

Abstract

HIV-infected people are at risk for neurocognitive impairment (HIV-Associated Neurocognitive Disorders - HAND). To evaluate whether the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), a widely used neurocognitive screening tool, could be a valid instrument for HAND identification, we evaluated 166 HIV-infected subjects. Our results showed that 96 (57.8%) HIV-infected scored RBANS Total Index Score <85 (at least one SD below the normal), 12 (7.2%) of them scored RBANS Total Index Score <70 (at least 2 SD below the normal, indicating a possible HIV-Associated Dementia). The more compromised areas were Immediate and Delayed Memory, and Attention. In the group with RBANS Total Index Score <85, there were significantly lower scores of Mini Mental State Examination (P = 0.0008), Clock Drawing Test (P = 0.0015) and higher score of Geriatric Depression Scale (P = 0.02) compared to the RBANS Total Index Score ≥85 group. Using a stepwise logistic regression, considering RBANS Total Index Score as dependent variable, we found a positive interaction with tenofovir/emtricitabine assumption (P = 0.027), Clock Drawing Test (P = 0.0125) and educational level (P = 0.0054). Being the viro-immunological markers not capable of predicting cognitive decline in HIV-infected individuals, our data suggest that RBANS may be a valid tool for the early identification of HIV-related cognitive impairment.

Keywords: ANI (Asymptomatic Neurocognitive Impairment); HAD (HIV-Associated Dementia); HAND (HIV-Associated Neurocognitive Disorders); MND (Mild Neurocognitive Dementia); RBANS (Repeatable Battery for the Assessment of Neuropsychological Status).

MeSH terms

  • Aged
  • Aging / psychology*
  • Cognition Disorders / diagnosis*
  • Cognition Disorders / psychology
  • Cognitive Dysfunction / diagnosis*
  • Cognitive Dysfunction / etiology
  • Dementia / diagnosis*
  • Female
  • HIV Infections / complications*
  • Humans
  • Male
  • Mass Screening / methods*
  • Mental Status and Dementia Tests / statistics & numerical data*
  • Neuropsychological Tests / statistics & numerical data*
  • Psychiatric Status Rating Scales / standards