TY - JOUR
T1 - Assessing Cognitive Functioning in People Living With HIV (PLWH)
T2 - Factor Analytic Results From CHARTER and NNTC Cohorts
AU - May, Pamela E.
AU - Heithoff, Abigail J.
AU - Wichman, Christopher S.
AU - Phatak, Vaishali S.
AU - Moore, David J.
AU - Heaton, Robert K.
AU - Fox, Howard S.
N1 - Funding Information:
Supported by the National Institutes of Health (NIH) under Award Number U24MH100925 to H.S.F. and U24MH100928 to D.J.M. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH, CHARTER, or NNTC. Support for the NNTC is provided by the National Institutes of Health (NIH) under Award Numbers U24MH100925 U24MH100928, U24MH100929, U24MH100930, and U24MH100931. The CHARTER studies were supported under NIH contracts N01 MH22005, HHSN271201000030C, and HHS-N-271-2010-00036C.
Publisher Copyright:
© 2020 Lippincott Williams and Wilkins. All rights reserved.
PY - 2020/3/1
Y1 - 2020/3/1
N2 - Background:Single summary scores, such as the Global Deficit Score, are often used to classify overall performance on neuropsychological batteries. The factor structure of test scores that underlie Global Deficit Score in studies of people living with HIV (PLWH) was assessed to determine whether individual test scores loaded onto a unitary factor to summarize performance.Setting:Secondary data analysis on baseline data of PLWH from National NeuroAIDS Tissue Consortium and CNS HIV Antiretroviral Therapy Effects Research (CHARTER) Study.Method:Primary analyses included testing model structure and fit of neuropsychological test scores with confirmatory and exploratory factor analyses. Secondary analyses involved receiver operating characteristic curves, and associations with psychosocial and medical variables.Results:Participants with confounds were excluded, leading to 798 (National NeuroAIDS Tissue Consortium) and 1222 (CHARTER) cases. When confirmatory factor analysis models were structured to be consistent with theoretically-based cognitive domains, models did not fit adequately. Per exploratory factor analyses, tests assessing speeded information processing, working memory, and executive functions loaded onto a single factor and explained the most variance in both cohorts. This factor tended to be associated with age, estimated premorbid ability, and aspects of substance use history. Its relation to age, in context of demographically corrected neuropsychological scores, suggested accelerated aging.Conclusion:Results indicate that individual neuropsychological tests did not load exactly onto expected domains, suggesting another framework for future analyses of cognitive domains. The possibility of a new index, and its use to assess cognitive impairment in PLWH, is suggested for further diagnostic and prognostic purposes.
AB - Background:Single summary scores, such as the Global Deficit Score, are often used to classify overall performance on neuropsychological batteries. The factor structure of test scores that underlie Global Deficit Score in studies of people living with HIV (PLWH) was assessed to determine whether individual test scores loaded onto a unitary factor to summarize performance.Setting:Secondary data analysis on baseline data of PLWH from National NeuroAIDS Tissue Consortium and CNS HIV Antiretroviral Therapy Effects Research (CHARTER) Study.Method:Primary analyses included testing model structure and fit of neuropsychological test scores with confirmatory and exploratory factor analyses. Secondary analyses involved receiver operating characteristic curves, and associations with psychosocial and medical variables.Results:Participants with confounds were excluded, leading to 798 (National NeuroAIDS Tissue Consortium) and 1222 (CHARTER) cases. When confirmatory factor analysis models were structured to be consistent with theoretically-based cognitive domains, models did not fit adequately. Per exploratory factor analyses, tests assessing speeded information processing, working memory, and executive functions loaded onto a single factor and explained the most variance in both cohorts. This factor tended to be associated with age, estimated premorbid ability, and aspects of substance use history. Its relation to age, in context of demographically corrected neuropsychological scores, suggested accelerated aging.Conclusion:Results indicate that individual neuropsychological tests did not load exactly onto expected domains, suggesting another framework for future analyses of cognitive domains. The possibility of a new index, and its use to assess cognitive impairment in PLWH, is suggested for further diagnostic and prognostic purposes.
KW - HIV
KW - HIV-associated neurocognitive disorder
KW - factor analysis
KW - neuropsychology
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U2 - 10.1097/QAI.0000000000002252
DO - 10.1097/QAI.0000000000002252
M3 - Article
C2 - 31913991
AN - SCOPUS:85079203169
SN - 1525-4135
VL - 83
SP - 251
EP - 259
JO - Journal of Acquired Immune Deficiency Syndromes
JF - Journal of Acquired Immune Deficiency Syndromes
IS - 3
ER -