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AIDS Res Hum Retroviruses. 2013 Jun;29(6):949-56. doi: 10.1089/AID.2012.0229. Epub 2013 Mar 20.

Deficits in self-awareness impact the diagnosis of asymptomatic neurocognitive impairment in HIV.

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1
School of Medicine, University of California San Francisco, San Francisco, CA 94143-1207, USA.

Abstract

A recent national survey of HIV(+) adults noted that nearly three-quarters of cognitively impaired individuals are categorized as having asymptomatic neurocognitive impairment (ANI), lacking documented compromise of everyday function. The clinical impact and long-term consequences of ANI are unknown and the importance of this asymptomatic diagnosis has raised concerns in clinical care settings where competing priorities often exist. In this study, we conducted structured tests of everyday functioning in a sample of HIV(+) subjects over 60 years of age and asked subjects to rate their performance relative to peers. We demonstrate that individuals with neuropsychological testing impairment often lack self-awareness of functional performance deficits. Specifically, ANI subjects rated functional performance similar to that of HIV-negative control subjects, despite noted deficits in objective measures of function. These findings have important implications for use of self-report of function in the diagnosis of HIV-associated neurocognitive disorders (HAND), likely underestimating symptomatic impairment.

PMID:
23432363
PMCID:
PMC3653396
DOI:
10.1089/AID.2012.0229
[Indexed for MEDLINE]
Free PMC Article
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