ORIGINAL ARTICLE: PDF OnlyPredicting occupational outcomes from neuropsychological test performance in older people with HIVBrouillette, Marie-Joséea,b,c,d; Koski, Lisae; Forcellino, Laurencef; Gasparri, Joséphineg; Brew, Bruce J.h,i; Fellows, Lesley K.d,j,k; Mayo, Nancy E.l,m,n; Cysique, Lucette A.oAuthor Information aDepartment of Psychiatry, McGill University, Montreal, Canada bChronic Viral Illness Service, McGill University Health Centre (MUHC), Montreal, Canada cInfectious Diseases and Immunity in Global Health Program, MUHC-RI, Montreal, Canada dCanadian Institutes of Health Research Canadian HIV Trials Network, Vancouver, BC, Canada eDepartment of Psychology, McGill University, Montreal, Canada fClinique NeuroÉvolution gBachelor of Behavioral Neuroscience, Concordia University, Montreal, CANADA hDepartments of Neurology and HIV Medicine, St Vincent's Hospital and Peter Duncan Neurosciences Unit, Sydney, Australia iFaculty of Medicine, University of Notre Dame, and Faculty of Medicine, University of New South Wales, Sydney, Australia jDepartment of Neurology and Neurosurgery, McGill University, Montreal, Canada kMontreal Neurological Hospital and Institute, McGill University, Montreal, Canada lDepartment of Medicine, School of Physical and Occupational Therapy, McGill University, Montreal, Canada mDivision of Clinical Epidemiology, McGill University Health Centre (MUHC), Center for Outcomes Research and Evaluation, Montreal, Canada nDivision of Geriatrics, McGill University Health Centre (MUHC), Montreal, Canada oSchool of Psychology, University of New South Wales, Australia. Correspondence to Marie-Josée Brouillette, McGill University Health Centre, 1001 Décarie, D02.4110, Montreal Quebec, Canada, H4A 3J1; e-mail: [email protected] Received 24 February, 2021 Revised 30 March, 2021 Accepted 13 April, 2021 Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Website (http://www.AIDSonline.com). AIDS: April 28, 2021 - Volume Publish Ahead of Print - Issue - doi: 10.1097/QAD.0000000000002927 Buy SDC PAP Metrics Abstract Objective: The ability to work is amongst the top concerns of people living with welltreated HIV. Cognitive impairment has been reported in many otherwise asymptomatic persons living with HIV and even mild impairment is associated with higher rates of occupational difficulties. There are several classification algorithms for HIV-Associated Neurocognitive Disorder (HAND) as well as overall scoring methods available to summarize neuropsychological performance. We asked which method best explained work status and productivity. Design: Participants (N = 263) drawn from a longitudinal Canadian cohort underwent neuropsychological testing. Methods: Several classification algorithms were applied to establish a HAND diagnosis and two summary measures (NPZ and GDS) were computed. Self-reported work status and productivity was assessed at each study visit (4 visits, 9 months apart). The association of work status with each diagnostic classification and summary measure was estimated using logistic regression. For those working, the value on the productivity scale was regressed within individuals over time, and the slopes were regressed on each neuropsychological outcome. Results: The application of different classification algorithms to the neuropsychological data resulted in rates of impairment that ranged from 28.5% to 78.7%. Being classified as impaired by any method was associated with a higher rate of unemployment. None of the diagnostic classifications or summary methods predicted productivity, at time of testing or over the following 36 months. Conclusion: Neuropsychological diagnostic classifications and summary scores identified participants who were more likely to be unemployed, but none explained productivity. New methods of assessing cognition are required to inform optimal workforce engagement. Copyright © 2021 Wolters Kluwer Health, Inc.