An Automated Virtual Reality Program Accurately Diagnoses HIV-Associated Neurocognitive Disorders in Older People...

Area of Science:

• Neuroscience
• Geriatrics
• Infectious Diseases

Background:

• HIV-associated neurocognitive disorders (HANDs) persist in older adults despite antiretroviral therapy.
• Diagnosing HAND is challenging due to its labor-intensive nature and need for expert administration of neuropsychological tests.
• Previous research demonstrated the feasibility and accuracy of the DETECT virtual reality program for assessing cognition in younger people with HIV (PWH).

Purpose of the Study:

• To evaluate the accuracy of the DETECT virtual reality program in identifying cognitive impairment in older PWH (≥60 years).
• To assess the correlation between DETECT performance and traditional neuropsychological test results for HAND diagnosis.
• To determine the utility of DETECT as a scalable cognitive screening tool for this population.

Main Methods:

• Enrolled 79 older PWH (≥60 years) on antiretroviral therapy with undetectable viral loads.
• Assessed HAND status using Frascati criteria and a comprehensive neuropsychological battery.
• Administered the DETECT cognition module and analyzed its association with HAND status and Global Deficit Score (GDS) using regression models.

Main Results:

• A significant correlation (r = 0.45, P < .001) was observed between the DETECT module and the neuropsychological battery.
• DETECT performance significantly predicted HAND status (b = -0.79, P < .001) and GDS impairment (b = -0.83, P < .001).
• DETECT demonstrated high accuracy in differentiating HAND status (AUC = 0.78) and detecting GDS impairment (AUC = 0.85).

Conclusions:

• The DETECT cognition module is a novel and effective tool for identifying cognitive impairment in older PWH.
• Its immersive and self-administered nature makes DETECT a promising, scalable cognitive screening battery.
• This virtual reality approach has the potential to improve the diagnosis and management of HANDs in aging populations.