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Jiang L, Xu M, Xia S, Zhu J, Zhou Q, Xu L, Shi C, Wu D. Reliability and validity of the electronic version of the Hopkins verbal learning test-revised in middle-aged and elderly Chinese people. Front Aging Neurosci 2023; 15:1124731. [PMID: 37377673 PMCID: PMC10292015 DOI: 10.3389/fnagi.2023.1124731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Accepted: 05/16/2023] [Indexed: 06/29/2023] Open
Abstract
Background The aging population is increasing, making it essential to have a standardized, convenient, and valid electronic memory test that can be accessed online for older people and caregivers. The electronic version of the Hopkins Verbal Learning Test-Revised (HVLT-R) as a test with these advantages and its reliability and validity has not yet been tested. Thus, this study examined the reliability and validity of the electronic version of the HVLT-R in middle-aged and elderly Chinese people to provide a scientific basis for its future dissemination and use. Methods We included 1,925 healthy participants aged over 40, among whom 38 were retested after 3-6 months. In addition, 65 participants completed both the pad and paper-and-pencil versions of the HVLT-R (PAP-HVLT-R). We also recruited 42 Alzheimer's disease (AD) patients, and 45 amnestic mild cognitive impairment (aMCI) patients. All participants completed the Pad-HVLT-R, the Hong Kong Brief Cognitive Test (HKBC), the Brief Visual Memory Test-Revised (BVMT-R), and the Logical Memory Test (LM). Results (1) Reliability: the Cronbach's α value was 0.94, the split-half reliability was 0.96. The test-retest correlation coefficients were moderate, ranging from 0.38 to 0.65 for direct variables and 0.16 to 0.52 for derived variables; (2) Concurrent validity: the Pad-HVLT-R showed a moderate correlation with the HKBC and BVMT-R, with correlation coefficients between total recall of 0.41 and 0.54, and between long-delayed recall of 0.42 and 0.59, respectively. It also showed a high correlation with the LM, with correlation coefficients of 0.72 for total recall and 0.62 for long-delayed recall; (3) Convergent validity: the Pad-HVLT-R was moderately correlated with the PAP version, with correlation coefficients ranging from 0.29 to 0.53 for direct variables and 0.15 to 0.43 for derived variables; (4) Discriminant capacity: the Pad-HVLT-R was effective in differentiating AD patients, as demonstrated by the ROC analysis with AUC values of 0.834 and 0.934 for total recall and long-delayed recall, respectively. Conclusion (1) The electronic version of HVLT-R has good reliability and validity in middle-aged and elderly Chinese people; (2) The electronic version of HVLT-R can be used as an effective tool to distinguish AD patients from healthy people.
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Affiliation(s)
- Lichen Jiang
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Ming Xu
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Shunyao Xia
- Institute of Mental Health, Peking University Sixth Hospital, Peking University, Beijing, China
- NHC Key Laboratory for Mental Health, National Clinical Research Center for Mental Disorders, Peking University Sixth Hospital, Peking University, Beijing, China
| | - Jiahui Zhu
- Institute of Mental Health, Peking University Sixth Hospital, Peking University, Beijing, China
- NHC Key Laboratory for Mental Health, National Clinical Research Center for Mental Disorders, Peking University Sixth Hospital, Peking University, Beijing, China
| | - Qi Zhou
- Institute of Mental Health, Peking University Sixth Hospital, Peking University, Beijing, China
- NHC Key Laboratory for Mental Health, National Clinical Research Center for Mental Disorders, Peking University Sixth Hospital, Peking University, Beijing, China
| | - Luoyi Xu
- Department of Psychiatry, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Chuan Shi
- Institute of Mental Health, Peking University Sixth Hospital, Peking University, Beijing, China
- NHC Key Laboratory for Mental Health, National Clinical Research Center for Mental Disorders, Peking University Sixth Hospital, Peking University, Beijing, China
| | - Daxing Wu
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
- Medical Psychological Institute, Central South University, Changsha, Hunan, China
- National Clinical Research Center for Mental Disorders, Changsha, Hunan, China
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Hetta. G, Jane. M, Michelle. H, Anna. D, Reuben. R, Greg. K, Andre. JJ, Leslie L, Thomas. M, GF. TK. Impact of HIV on Cognitive Performance in Professional Drivers. J Acquir Immune Defic Syndr 2022; 89:527-536. [PMID: 34974470 PMCID: PMC9058184 DOI: 10.1097/qai.0000000000002899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Accepted: 12/06/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND The intellectually demanding modern workplace is often dependent on good cognitive health, yet there is little understanding of how neurocognitive dysfunction related to HIV presents in employed individuals working in high-risk vocations such as driving. HIV-associated neurocognitive impairment is also associated with poorer long-term cognitive, health, and employment outcomes. SETTING This study, set in Cape Town, South Africa, assessed the effects of HIV on neuropsychological test performance in employed male professional drivers. METHOD We administered a neuropsychological test battery spanning 7 cognitive domains and obtained behavioral data, anthropometry, and medical biomarkers from 3 groups of professional drivers (68 men with HIV, 55 men with cardiovascular risk factors, and 81 controls). We compared the drivers' cognitive profiles and used multiple regression modeling to investigate whether between-group differences persisted after considering potentially confounding sociodemographic and clinical variables (ie, income, home language, depression, and the Framingham risk score). RESULTS Relative to other study participants, professional drivers with HIV performed significantly more poorly on tests assessing processing speed (P < 0.003) and attention and working memory (P = 0.018). Group membership remained a predictor of cognitive performance after controlling for potential confounders. The cognitive deficits observed in men with HIV were, however, largely characterized as being mild or asymptomatic. Consistent with this characterization, their relatively poor performance on neuropsychological testing did not generalize to self-reported impairment on activities of daily living. CONCLUSION Drivers with HIV may be at risk of poorer long-term health and employment outcomes. Programs that monitor and support their long-term cognitive health are needed.
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Affiliation(s)
- Gouse Hetta.
- HIV Mental Health Research Unit and Neurosciences Institute, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Masson Jane.
- HIV Mental Health Research Unit and Neurosciences Institute, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Henry Michelle.
- Centre for Higher Education Development, University of Cape Town, Cape Town, South Africa
| | - Dreyer Anna.
- HIV Mental Health Research Unit and Neurosciences Institute, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Robbins Reuben.
- HIV Center for Clinical and Behavioral Science, New York State Psychiatric Institute and Columbia University, New York, USA
| | - Kew Greg.
- School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
| | - Joska John Andre.
- HIV Mental Health Research Unit and Neurosciences Institute, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - London Leslie
- School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
| | - Marcotte Thomas.
- HIV Neurobehavioral Research Program, Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
| | - Thomas Kevin GF.
- ACSENT Laboratory, Department of Psychology, University of Cape Town, Cape Town, South Africa
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Nyamayaro P, Gouse H, Hakim J, Robbins RN, Chibanda D. Neurocognitive impairment in treatment-experienced adults living with HIV attending primary care clinics in Zimbabwe. BMC Infect Dis 2020; 20:383. [PMID: 32471350 PMCID: PMC7257139 DOI: 10.1186/s12879-020-05090-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Accepted: 05/13/2020] [Indexed: 01/24/2023] Open
Abstract
Background HIV affects the central nervous system resulting in HIV associated neurocognitive impairment (NCI) in approximately 50% of people living with HIV. It typically affects memory, learning, working memory, fine motor skills, speed of information processing, verbal fluency and executive functioning cognitive domains. NCI can affect adherence to antiretroviral therapy (ART), employability, driving ability and activities of daily living. NCI is not routinely screened for in Zimbabwe, and the burden is not known in this setting. The objectives of this study were: 1) To determine NCI prevalence using a comprehensive neuropsychological battery at two primary health care clinics in Harare; 2) To assess the pattern of cognitive impairment across cognitive domains using a gold standard neuropsychological (NP) battery in HIV-positive patients compared to HIV-negative controls. Methods Inclusion criteria: 18 years or older; minimum 7 years education; no neurological or psychiatric disorders. HIV-positive participants were on ART for ≥3 months; HIV-negative participants had a confirmed HIV negative status in the past month. A comprehensive NP battery, functional assessments, demographic and medical history questionnaires were administered. The NP battery consisted of tests assessing memory, learning, working memory, fine motor skills, speed of information processing, verbal fluency and executive functioning. Results Two-hundred-and-thirty-one participants were recruited. Of those, 155 were HIV-positive (Female = 70%, Age M = 37.8; SD 11.2) and 76 HIV-negative (Female = 63%, Age M = 31.2; SD 9.9). HIV-positive participants were on ART for an average of 6 years. NCI was present in 49.7% HIV positive participants. Compared to HIV-negative participants, the HIV-positive group had significantly poorer scores in 5 out of 7 cognitive domains. A good level of education is negatively correlated with NCI. Conclusions NCI prevalence in HIV-positive population Zimbabwe is consistent with global estimates. NCI persists in adults who are on ART. Routine assessment of NCI in adults attending primary care clinics using this adapted battery is therefore important so that they are identified early and are provided the necessary interventions.
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Affiliation(s)
- Primrose Nyamayaro
- Department of Psychiatry, College of Health Sciences, African Mental Health Research Initiative, University of Zimbabwe, Harare, Zimbabwe.
| | - Hetta Gouse
- Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - James Hakim
- Department of Medicine, College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe
| | - Reuben N Robbins
- New York State Psychiatric Institute, Columbia University, New York, NY, USA
| | - Dixon Chibanda
- Department of Psychiatry, College of Health Sciences, African Mental Health Research Initiative, University of Zimbabwe, Harare, Zimbabwe.,Centre for Global Mental Health, London School of Hygiene and tropical Medicine, London, UK
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Katzef C, Henry M, Gouse H, Robbins RN, Thomas KGF. A culturally fair test of processing speed: Construct validity, preliminary normative data, and effects of HIV infection on performance in South African adults. Neuropsychology 2019; 33:685-700. [PMID: 30869933 PMCID: PMC7379145 DOI: 10.1037/neu0000539] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVES Impaired processing speed (PS) is a feature of cognitive profiles associated with neurological disorders particularly prevalent in low- or middle-income countries (LMICs). However, commonly used PS tests are not validated for use in LMICs. We assessed, using a sample of healthy South African adults, the construct validity of PS tests contained within NeuroScreen (a tablet-based application and test battery designed to be culturally fair), and established preliminary normative data for those tests (Study 1). Moreover, because South Africa has the highest population prevalence of people living with HIV and PS deficits are a core feature of HIV-associated cognitive impairment, we assessed whether NeuroScreen could detect PS impairment in a sample of HIV-infected South African adults (Study 2). METHODS In Study 1 (N = 112 healthy adults) and Study 2 (the Study 1 sample, plus n = 102 HIV-infected adults), we administered Neuroscreen and a standardized paper-and-pencil neuropsychological test battery. RESULTS In Study 1, factor analyses indicated that NeuroScreen PS scores loaded onto one factor and converged with scores on paper-and-pencil PS tests. Regression modeling indicated that age significantly predicted NeuroScreen PS performance (i.e., younger participants performed better). In Study 2, HIV-infected participants performed significantly more poorly on NeuroScreen PS tests than their HIV-uninfected counterparts. Moreover, a significantly larger proportion of HIV-infected participants displayed impaired PS when judged against the regression-based norms. CONCLUSIONS These results suggest that NeuroScreen has cross-cultural utility in assessing adult PS performance, and that it might be useful in tracking trajectories of PS decline within HIV infection. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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Affiliation(s)
| | | | - Hetta Gouse
- Department of Psychiatry and Mental Health, University of Cape Town
| | - Reuben N Robbins
- HIV Center for Clinical and Behavioral Studies, Columbia University
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Nyamayaro P, Chibanda D, Robbins RN, Hakim J, Gouse H. Assessment of neurocognitive deficits in people living with HIV in Sub Saharan Africa: A systematic review. Clin Neuropsychol 2019; 33:1-26. [PMID: 31043112 DOI: 10.1080/13854046.2019.1606284] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Objective: People living with HIV (PLWH) are at risk for HIV-Associated Neurocognitive Disorders (HAND)/Neurocognitive Impairment (NCI). HIV prevalence in Sub-Saharan Africa (SSA) is high, but neuropsychological screening and testing for NCI among HIV-infected individuals is not done frequently. This systematic review aims to establish how NCI among HIV-infected individuals is being assessed in SSA, if and how the tests are adapted, if norms exist and identify personnel who administer them.Method: We searched PubMed, Medline, EBSCO, PsycINFO, and Web of Science. Two reviewers screened the articles for inclusion and risk of bias. We included studies from SSA with a comprehensive neuropsychological assessment battery.Results: We retrieved 212 articles and 23 articles met inclusion criteria. The most commonly used tests were the Color Trails Test 1, Color Trails Test 2, and the WAIS III Digit Symbol Test. Some tests were translated into French (Cameroon), Luganda (Uganda), Chichewa (Malawi), isiXhosa (South Africa), and Afrikaans (South Africa). Some verbal learning tests were adapted to reflect culturally appropriate language. Test administrators were either non-specialized personnel supervised by clinical neuropsychologists or clinical psychologists.Conclusion: Overall, the tests used are similar to the tests being used globally to assess NCI among HIV-infected individuals and there is a general consistency across countries. However, there is generally a lack of norms for the tests and the process of adaptation is not always well described. Future research should establish whether these tests measure neuropsychological constructs as successfully as they do in western populations where the tests were developed.
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Affiliation(s)
| | - Dixon Chibanda
- Department of Psychiatry, University of Zimbabwe, Harare, Zimbabwe.,Centre for Global Mental Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Reuben N Robbins
- New York State Psychiatric Institute, Columbia University, New York, United States
| | - James Hakim
- Department of Medicine, University of Zimbabwe, Harare, Zimbabwe
| | - Hetta Gouse
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
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