Affiliations 

  • 1 Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
  • 2 Centre of Excellence for Research in AIDS (CERIA), University of Malaya, Kuala Lumpur, Malaysia
  • 3 Department of Medicine, University of Malaya, Kuala Lumpur, Malaysia
  • 4 Centre of Excellence for Research in AIDS (CERIA), University of Malaya, Kuala Lumpur, Malaysia. reena@um.edu.my
  • 5 Neuroscience Research Australia, School of Medical Sciences, Faculty of Medicine, The University of New South Wales, Sydney, NSW, Australia
AIDS Behav, 2018 Oct;22(10):3226-3233.
PMID: 29508103 DOI: 10.1007/s10461-018-2073-x

Abstract

This study determines the optimal cut-off scores for the Montreal Cognitive Assessment (MoCA) to detect HIV-associated neurocognitive disorders (HAND) in a multi-ethnic Malaysian HIV-positive cohort by developing demographically corrected normative standards among 283 HIV-negative community-based controls with overlapping demographic characteristics. The norms (corrected for age, sex, education, ethnicity) were applied to 342 HIV-positive virally suppressed individuals on cART. Impairment rates were classified using the Global Deficit Score (GDS ≥ .5) method. The MoCA was also scored according to the recommended cut-off of ≤ 26, and functional decline was applied to both impairment definitions to classify HAND per the Frascati criteria. The ≤ 26 cut-off considerably overestimated cognitive impairment in both samples (59.4% HIV-negative; 69.3% HIV-positive). In contrast, corrected scores yielded impairment rates consistent with what has been reported internationally in virally suppressed cohorts (23.4% with 83.3% mild impairment, 16.7% moderate impairment). A supplemental file allowing the computation of corrected MoCA scores and impairment status is included.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.