# Detect: A novel device to assess how HIV affects neurocognitive decline and postural instability in older adults at risk for Alzheimer's Disease

> **NIH NIH R01** · UNIVERSITY OF CALIFORNIA, SAN DIEGO · 2021 · $783,090

## Abstract

Project Summary/Abstract
This application is in response to the NIA’s Strategic Directions Goal D-3, which calls for better tools to assess
cognitive function in the clinic, primary care setting, and home environment in order to distinguish persons at risk
for developing Alzheimer’s disease (AD) from persons not at risk. Persons living with HIV (PLHIV) are now living
well into the age demographic in which they are at increasing risk for developing AD. Because up to 50% of
PLHIV experience cognitive impairment from HIV or related factors that often include memory problems, AD may
go unidentified in a significant proportion of older PLHIV. There is a pressing need in geriatric neuroHIV for the
ability to accurately identify and disentangle HIV- and AD-associated cognitive impairment and predict individuals
who are at risk for further cognitive decline. Evidence from epidemiological studies suggests that sensory (e.g.,
auditory processing) and motor (e.g., balance) impairments are observed more frequently in PLHIV compared
to the general population of a similar age and that these impairment may impact the progression of cognitive
impairment in PLHIV and in AD. Building on substantial evidence demonstrating that virtual reality is widely
accepted among older adults, we propose to use a novel and portable 3-D virtual reality automated tool, called
DETECT, to accurately measure cognition decline and changes in postural stability over time in older PLHIV with
and without amnestic mild cognitive impairment (aMCI), a precursor to AD. DETECT was developed for rapid
and brief cognitive testing in diverse settings, such as busy geriatric HIV clinics or the home, and can accurately
discriminate between normal cognition, MCI, and dementia. Additionally, our pilot work indicates that DETECT
is a sensitive screening tool for differentiating between normal cognition and HIV-associated neurocognitive
disorder (HAND) in PLHIV. The system is also accurate for diagnosing postural instability using a novel technique
that obviates the need for standing and ambulation. To expand on this work, we propose a two site (UCSD and
Emory) prospective study of 120 older individuals representing three different clinical phenotypes: PLHIV with
HAND and aMCI (HAND+/aMCI+), PLHIV with HAND but without aMCI (HAND+/aMCI-), and HIV-uninfected
persons with aMCI (HIV-/aMCI+). An empirically-based neuropsychological diagnostic approach will be used to
identify aMCI among PLHIV. We will use DETECT to: (Aim 1) compare the determinants of cognitive decline in
these groups, and (Aims 2 and 3) understand how non-cognitive functional changes such as postural instability,
hearing loss, and central auditory processing dynamically influence cognitive decline in these groups. Our
longitudinal study design will allow us to better understand how cognitive change differs over time between these
groups of individuals. The long-term goal of this work is to bring rapid, accurate tools that can identify t...

## Key facts

- **NIH application ID:** 10076747
- **Project number:** 5R01AG062387-03
- **Recipient organization:** UNIVERSITY OF CALIFORNIA, SAN DIEGO
- **Principal Investigator:** Albert Anderson
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $783,090
- **Award type:** 5
- **Project period:** 2019-02-15 → 2023-11-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10076747

## Citation

> US National Institutes of Health, RePORTER application 10076747, Detect: A novel device to assess how HIV affects neurocognitive decline and postural instability in older adults at risk for Alzheimer's Disease (5R01AG062387-03). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10076747. Licensed CC0.

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