Although HIV-associated dementia (HAD), the most severe form of HAND, has decreased markedly in the era of combination antiretroviral therapy (cART), milder forms of neurocognitive impairment continue to persist and adversely impact quality of life, reduce daily functioning, employment and adherence to ART, and increase mortality.

HIV-associated neurocognitive disorders (HAND) continues to affect up to half of all people living with HIV (PLWH). A supplemental file allowing the computation of corrected MoCA scores and impairment status is included. In contrast, corrected scores yielded impairment rates consistent with what has been reported internationally in virally suppressed cohorts (23.4% with 83.3% mild impairment, 16.7% moderate impairment). The ≤ 26 cut-off considerably overestimated cognitive impairment in both samples (59.4% HIV-negative 69.3% HIV-positive). The MoCA was also scored according to the recommended cut-off of ≤ 26, and functional decline was applied to both impairment definitions to classify HAND per the Frascati criteria. Impairment rates were classified using the Global Deficit Score (GDS ≥.

The norms (corrected for age, sex, education, ethnicity) were applied to 342 HIV-positive virally suppressed individuals on cART. This study determines the optimal cut-off scores for the Montreal Cognitive Assessment (MoCA) to detect HIV-associated neurocognitive disorders (HAND) in a multi-ethnic Malaysian HIV-positive cohort by developing demographically corrected normative standards among 283 HIV-negative community-based controls with overlapping demographic characteristics.

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