Development of normative neuropsychological performance in Thailand for the assessment of HIV-associated neurocognitive disorders
Development of normative neuropsychological performance in Thailand for the assessment of HIV-associated neurocognitive disorders
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DOI：
10.1080/13803395.2012.733682
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发表时间：
2013-01-01
影响因子：
2.2
通讯作者：
Ananworanich, Jintanat
中科院分区：
文献类型：
--
作者：
Heaps, Jodi;Valcour, Victor;Ananworanich, Jintanat
需要对艾滋病毒相关神经认知障碍（HAND）进行国际研究，以确定与认知障碍相关的病毒和宿主因素，特别是超过80%的艾滋病毒阳性受试者居住在资源有限的环境中。最近对HAND的诊断命名要求将认知表现与当地规范数据进行比较。为了评估对当地规范的需求，我们将泰国当地获得的规范数据与西方规范进行了比较。目前的研究检查了477名血清阴性的泰国参与者（男性211人，女性266人）的认知表现，他们完成了一系列对艾滋病毒认知变化敏感的测试。研究对象被分为3个年龄组（20-34岁；35-49岁；50-65岁）和4个教育水平（未受教育或初等教育、中等以下学历、高中/大专学历、学士或以上学历）。将泰国队列与血清阴性的美国队列（n=236，男性= 198，女性= 38）在多项指标上进行比较（使用协方差分析，ANCOVA），以检验表现的文化差异。规范数据提供了年龄和教育分层。泰国组和美国组在所有神经心理学测试中表现明显不同，除了语言流畅性。泰国组在语言学习（p < 0.001）、记忆（p < 0.001）和精神运动速度（p < 0.001）方面表现更好。与美国人相比，泰国人的教育水平是一个更有力的预测指标。这些结果突出了继续需要在当地人口中发展规范数据。使用西方规范作为比较组可能导致在文化不同的群体中不准确地识别HAND。
International studies of HIV-associated neurocognitive disorder (HAND) are needed to determine the viral and host factors associated with cognitive impairment particularly as more than 80% of HIV+ subjects reside in resource-limited settings. Recent diagnostic nomenclature of HAND requires comparison of cognitive performance specifically to local normative data. To evaluate this need for local norms, we compared normative data obtained locally in Thailand to Western norms. The current study examined cognitive performance in 477 seronegative Thai participants (male = 211, female = 266) who completed a battery of tests sensitive to cognitive changes in HIV. The cohort was divided into three age brackets (20-34; 35-49; 50-65 years) and four educational levels (no education or primary education, less than secondary certificate, high-school/associates degree, bachelor's degree or greater). The Thai cohort was compared (using analysis of covariance, ANCOVA) on a number of measures to a seronegative US cohort (n=236; male = 198, female = 38) to examine cultural differences in performance. Normative data are provided with age and education stratification. The Thai and US groups performed significantly differently on all neuropsychological measures with the exception of verbal fluency. The Thai group performed better on measures of verbal learning (p < .001) and memory (p < .001) and measures of psychomotor speed (p < .001). Education was a more powerful predictor of performance in the Thai cohort than in the US group. These results highlight the continued need for the development of normative data within local populations. The use of Western norms as a comparison group could lead to inaccurate identification of HAND in culturally distinct groups.