Document Detail

Psychomotor slowing in HIV infection: a predictor of dementia, AIDS and death.
MedLine Citation:
PMID:  8972422     Owner:  NLM     Status:  MEDLINE    
The objective of this study was to determine if sustained decline in psychomotor speed tests is associated with an increased risk of progression to dementia, acquired immunodeficiency syndrome (AIDS), or mortality in human immunodeficiency virus (HIV)-1-infected homosexual men in the Baltimore site of the Multicenter AIDS Cohort-Study (MACS). Clinical and neuropsychological data were obtained on 291 HIV+ homosexual men seen semi-annually over a nine year period (1986-1994). A proportional hazards model was used to assess the predictive value of sustained psychomotor slowing (defined as a 2.0 standard deviation (s.d.) decline in performance on either the Symbol Digit Modalities test or Trailmaking test at two consecutive evaluations). Time-dependent co-variates included in the model were sustained psychomotor slowing, number of attended visits, CD4+ lymphocyte count, hemoglobin and antiretroviral medication use. HIV+ participants with and without sustained psychomotor slowing were compared. Outcome variables were the development of dementia, AIDS and death. HIV+ subjects with sustained psychomotor slowing had an increased hazard of dementia (Risk ratio (RR) = 5.0, P = 0.008), AIDS (RR = 2.4, P = 0.02), and death (RR = 2.0, P = 0.04). A similar analysis using sustained cognitive decline in one domain from a more extensive neuropsychological test battery failed to show any predictive value. Sustained decline in psychomotor performance in HIV infection was predictive of dementia, AIDS and death. This brief neuropsychological test battery may be useful for early detection of HIV+ individuals with a poorer prognosis who may benefit from more aggressive treatment to prevent HIV dementia.
N C Sacktor; H Bacellar; D R Hoover; T E Nance-Sproson; O A Selnes; E N Miller; G J Dal Pan; C Kleeberger; A Brown; A Saah; J C McArthur
Publication Detail:
Type:  Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Journal of neurovirology     Volume:  2     ISSN:  1355-0284     ISO Abbreviation:  J. Neurovirol.     Publication Date:  1996 Dec 
Date Detail:
Created Date:  1997-03-17     Completed Date:  1997-03-17     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  9508123     Medline TA:  J Neurovirol     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  404-10     Citation Subset:  IM; X    
Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
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MeSH Terms
AIDS Dementia Complex / mortality*
Acquired Immunodeficiency Syndrome / mortality*,  psychology,  therapy
Cognition Disorders / diagnosis,  virology
Cohort Studies
HIV Infections / complications*,  psychology,  therapy
Longitudinal Studies
Neuropsychological Tests
Predictive Value of Tests
Psychomotor Disorders / diagnosis,  virology*
Risk Factors
Treatment Outcome
Grant Support

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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