| Memory-Registration – Give four words to recall (dog, hat, bean, red) – 1 second to say each. Then ask the patient to repeat all four words after you have said them. Repeat words if the patient does not recall them all immediately. Tell the patient you will ask for recall of the words again a bit later. |
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| 1. |
Motor Speed: Have the patient tap the first two fingers of the non-dominant hand as widely and as quickly as possible.
- 4 = 15 in 5 seconds
- 3 = 11-14 in 5 seconds
- 2 = 7-10 in 5 seconds
- 1 = 3-6 in 5 seconds
- 0 = 0-2 in 5 seconds
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| 2. |
Psychomotor Speed: Have the patient perform the following movements with the non-dominant hand as quickly as possible:
- Make a fist and rest it on a flat surface.
- Put hand flat on surface with palm down.
- Put hand perpendicular to flat surface on the side of the 5th digit. Demonstrate and have patient perform twice for practice.
- 4 = 4 sequences in 10 seconds
- 3 = 3 sequences in 10 seconds
- 2 = 2 sequences in 10 seconds
- 1 = 1 sequence in 10 seconds
- 0 = unable to perform
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| 3. |
Memory-Recall: Ask the patient to recall the four words. For words not recalled, prompt with a semantic clue as follows: animal (dog); piece of clothing (hat); vegetable (bean); color (red).
- Give 1 point for each word spontaneously recalled.
- Give 0.5 points for each correct answer after prompting
- Maximum – 4 points.
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Total International HIV Dementia Scale Score: This is the sum of the scores on items 1-3. The maximum possible score is 12 points.
A patient with a score of ≤ 10 should be evaluated further for possible dementia. In this case, consider CNS nuclear magnetic resonance imaging, lumbar puncture including CSF HIV RNA measurement, and consultation with neurologist or neuropsychologist. |
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