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The Montreal Cognitive Assessment to Screen for Cognitive Impairment in HIV Patients Older Than 60 Years

Milanini, Benedetta Psy*; Wendelken, Lauren A. MS; Esmaeili-Firidouni, Pardis BS; Chartier, Maggie PsyD, MPH; Crouch, Pierre-Cedric NP, RN§; Valcour, Victor MD, PhD†,‖

JAIDS Journal of Acquired Immune Deficiency Syndromes: September 1st, 2014 - Volume 67 - Issue 1 - p 67–70
doi: 10.1097/QAI.0000000000000220
Brief Report: Clinical Science

Abstract: Progress in HIV treatments has led to HIV-infected patients living into their 60s and older. Because HIV-associated neurocognitive disorder (HAND) in older age is associated with more executive dysfunction, cognitive screening instruments tapping this domain may be optimal. We examined the Montreal Cognitive Assessment to identify HAND in 67 HIV-infected patients older than 60 years, of which 40% were diagnosed with HAND. Receiver operating characteristic curve identified an optimal cutpoint of ≤ 25 for HAND with a sensitivity of 72% and specificity of 67%. We conclude that the Montreal Cognitive Assessment has only moderate performance characteristics for cognitive screening of HIV-infected elders.

*Institute of Clinical Infectious Diseases, Catholic University of Sacred Heart, Rome, Italy;

Memory and Aging Center, Department of Neurology, University of California—San Francisco, San Francisco, CA;

Department of Veterans Affairs Medical Center San Francisco San Francisco, CA;

§Department of Community Health Systems, School of Nursing, University of California—San Francisco, San Francisco, CA; and

Division of Geriatric Medicine, Department of Medicine, University of California—San Francisco, San Francisco, CA.

Correspondence to: Victor Valcour, MD, PhD, Room NS 192C, Memory and Aging Center, University of California—San Francisco, 675 Nelson Rising Lane, San Francisco, CA 94158 (e-mail:

Supported by the following grants from the National Institutes of Health: K24-MH-098759 (V.V.), P50-AG-023501 (Alzheimer Disease Research Center, Priniciple Investigator: Bruce Miller); P30-AI-027763 [University of California—San Francisco (UCSF)/Gladstone Institutes of Virology and Immunology Center for AIDS Research), and the UL1-RR-024131 (UCSF General Clinical Research Center). Additional support received from the Larry L. Hillblom Foundation and the UCSF AIDS Research Institute.

The authors have no conflicts of interest to disclose.

Received February 07, 2014

Accepted April 11, 2014

© 2014 by Lippincott Williams & Wilkins