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J Acquir Immune Defic Syndr. 2014 Sep 1;67(1):67-70. doi: 10.1097/QAI.0000000000000220.

The Montreal cognitive assessment to screen for cognitive impairment in HIV patients older than 60 years.

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*Institute of Clinical Infectious Diseases, Catholic University of Sacred Heart, Rome, Italy; †Memory and Aging Center, Department of Neurology, University of California-San Francisco, San Francisco, CA; ‡Department of Veterans Affairs Medical Center San Francisco San Francisco, CA; §Department of Community Health Systems, School of Nursing, University of California-San Francisco, San Francisco, CA; and ‖Division of Geriatric Medicine, Department of Medicine, University of California-San Francisco, San Francisco, CA.


Progress in HIV treatments has led to HIV-infected patients living into their 60s and older. Because HIV-associated neurocognitive disorder (HAND) in older age is associated with more executive dysfunction, cognitive screening instruments tapping this domain may be optimal. We examined the Montreal Cognitive Assessment to identify HAND in 67 HIV-infected patients older than 60 years, of which 40% were diagnosed with HAND. Receiver operating characteristic curve identified an optimal cutpoint of ≤ 25 for HAND with a sensitivity of 72% and specificity of 67%. We conclude that the Montreal Cognitive Assessment has only moderate performance characteristics for cognitive screening of HIV-infected elders.

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