The HIV Dementia Scale (HDS) can be used to screen a patient with HIV disease for evidence of dementia. This can help identify a patient who should have a more complete neurologic examination. The authors are from the Johns Hopkins University in Baltimore.
Parameters:
(1) memory registration and recall of 4 items (dog, hat, green, peach)
(2) attention
(3) psychomotor speed
(4) construction, with drawing a 3 dimensional cube
Task Descriptions:
(1) memory registration and recall: At the beginning of the session ask the person to memorize 4 words – dog, hat, green and peach. The patient is asked to resay the words after being introduced to them. After the test of psychomotor skill (about 10 minutes later) the patient is asked to recall the 4 words. If the person is unable to recall the word, the interviewer uses a clue ("animal", "clothing", "color", "fruit") to try and trigger recall.
(2) attention task: The patient is assessed for errors during 20 trials of anti-saccadic eye movements. The patient is initially asked to focus on the examiner's nose, then on the examiner's moving finger, then on the examiner's non-moving finger. The patient is given 20 trials of keeping her/his eyes on the non-moving finger while the other finger moves. An error is recorded for each time the patient looks towards the moving finger instead of the non-moving one.
(3) psychomotor speed: Measure the number of seconds to write the alphabet in upper case letters horizontally across the page.
(4) drawing a 3 dimensional cube: Measure the number of seconds required to copy a line drawing of a cube.
|
Parameter |
Finding |
Points |
|
memory recall of dog |
recall without prompting |
1 |
|
|
recall with promoting |
0.5 |
|
|
unable to recall |
0 |
|
memory recall of hat |
recall without prompting |
1 |
|
|
recall with promoting |
0.5 |
|
|
unable to recall |
0 |
|
memory recall of green |
recall without prompting |
1 |
|
|
recall with promoting |
0.5 |
|
|
unable to recall |
0 |
|
memory recall of peach |
recall without prompting |
1 |
|
|
recall with promoting |
0.5 |
|
|
unable to recall |
0 |
|
attention |
<= 3 errors |
4 |
|
|
4 errors |
3 |
|
|
5 errors |
2 |
|
|
6 errors |
1 |
|
|
> 6 errors |
0 |
|
psychomotor speed |
<= 21 seconds |
6 |
|
|
21.1 to 24 seconds |
5 |
|
|
24.1 to 27 seconds |
4 |
|
|
27.1 to 30 seconds |
3 |
|
|
30.1 to 33 seconds |
2 |
|
|
33.1 to 36 seconds |
1 |
|
|
> 36 seconds |
0 |
|
construction of cube |
< 25 seconds |
2 |
|
|
25 – 35 seconds |
1 |
|
|
> 35 seconds |
0 |
HIV dementia scale =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 16
• A score <= 10 was associated with dementia.
Performance of score:
• Sensitivity 80%, specificity 91%.
• Positive predictive value 78%; diagnostic efficiency 84%.
• The score may not be sensitive in detecting mild dementia in highly educated persons.
Purpose: To evaluate a patient with HIV disease for evidence of dementia using the HIV Dementia Scale of Power et al.
Specialty: Neurology
Objective: other testing, selection
ICD-10: F02.4,
