Assessing neurocognitive functioning among adults ageing with and without HIV at the Kenyan Coast: measurement issues and correlates
Rattachement africain : Afrique du Sud, Kenya, gb. Niveau de preuve : code pays fourni par la source.
Le résumé fourni par la source
Background: Cognitive impairment is one of the most prevalent complications of HIV infection, with significant medical and functional impacts. However, valid, and reliable assessment tools are lacking for the newly emergent ageing population of people living with HIV (PLWH) in many parts of sub-Saharan Africa (SSA), including Kenya. Without these tools, critical intervention opportunities, e.g., psychoeducation, treatment and additional support, are missed. To bridge this gap in Kenya, we adapted the Oxford Cognitive Screen Plus (OCSPlus), a tablet-based cognitive assessment tool designed for low-literacy settings, with adults ageing with HIV ≥ 50 years and their uninfected peers. This study examines the acceptability, reliability, and validity of the OCSPlus tool among older Kenyan adults and provides an initial understanding of the cognitive performance of these adults (by HIV status) and the biopsychosocial factors associated with their cognitive performance. Methods: In a cross-sectional sample of 440 older adults (257 living with HIV), we administered the OCSPlus tool alongside the Raven's Standard Progressive Matrices (RSPM), the International HIV Dementia Scale (IHDS), and health and sociodemographic assessments. Results: There was a high level of acceptability of OCSPlus by participants and test administrators. OCSPlus demonstrated good test-retest reliability. Acceptable correlations between individual OCSPlus sub-tasks and conventional tests (RSPM and IHDS) were also observed for convergent validity. Regarding cognitive performance, older adults living with HIV (OALWH) presented with significantly lower scores on language (picture naming task), executive function, and the IHDS overall score compared to their uninfected peers. However, OALWH performed significantly better on memory domain (orientation, word encoding and word recall tasks), non-verbal intelligence and processing speed. There were no differences in attention domain. Cognitive performance as assessed by OCSPlus was significantly associated with behavioural and lifestyle factors (physical activity, sleeping difficulties, obesity, and sexual activity), sociodemographic factors (age, sex, educational status, household income, household size and asset index), medical or treatment factors (self-reported urinary incontinence, hearing problems, history of TB, seeking services of traditional healers, antiretroviral therapy (ART) regimen change, being on 3rd line ART treatment) and psychosocial factors including ageism and food insecurity. Conclusion: We demonstrated the feasibility of OCSPlus administration by trained lay persons, its acceptability, and preliminary reliability and validity among low-literacy older adults on the Kenyan coast. Mean cognitive scores were mixed across the two groups. Cognitive performance was associated with several biopsychosocial factors spanning behavioural/lifestyle, sociodemographic, psychosocial, medical and treatment factors. Further validation studies and epidemiological research are needed to understand better the utility of OCSPlus and the cognitive function of these adults.
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Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Assessing neurocognitive functioning among adults ageing with and without HIV at the Kenyan Coast: measurement issues and correlates
- Date Crossref
- 04/12/2025
- Éditeur
- Frontiers Media SA
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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University of the Witwatersrand University of the Witwatersrand, Afrique du Sud (code pays fourni par la source)Université ou école supérieure
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Kenya Medical Research Institute Centre for Geographic Medicine Research Coast Kilifi, Kenya (code pays fourni par la source)Structure de recherche
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Aga Khan University Nairobi Institute for Human Development Aga Khan University Nairobi, Kenya (code pays fourni par la source)Université ou école supérieure
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KEMRI-Wellcome Trust Research Programme Kenya (code pays fourni par la source)Structure de recherche
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Agincourt Health and Socio-Demographic Surveillance System Afrique du Sud (code pays fourni par la source)Institution
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Oxford Research Group pays non établi dans la noticeOrganisation à but non lucratif
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Science Oxford pays non établi dans la noticeOrganisation à but non lucratif
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Pwani University Department of Public Health Kilifi, Kenya (code pays fourni par la source)Université ou école supérieure
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Warneford Hospital pays non établi dans la noticeÉtablissement de santé
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University of Oxford Doctoral Training Centre pays non établi dans la noticeUniversité ou école supérieure
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School of Public Health MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt) University of the Witwatersrand, Afrique du Sud (pays nommé en fin d’affiliation)Université ou école supérieure
University of the Witwatersrand (University of the Witwatersrand, Afrique du Sud), Centre for Geographic Medicine Research Coast — Kenya Medical Research Institute (Kilifi, Kenya) et Institute for Human Development — Aga Khan University Nairobi (Aga Khan University Nairobi, Kenya), avec 8 autres affiliations. Pays d’affiliation : Afrique du Sud, Kenya.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.