# Improving Assessment for Neurocognitive Impairment Among Older Adults with Alzheimer's Disease and Related Dementias

> **NIH NIH R01** · NEW YORK STATE PSYCHIATRIC INSTITUTE DBA RESEARCH FOUNDATION FOR MENTAL HYGIENE, INC · 2020 · $353,645

## Abstract

South Africa (SA), a resource limited setting with the world’s largest population of people living with HIV, has
hundreds of thousands of youth living with perinatally acquired HIV (PHIV) who are rapidly becoming
adolescents and young adults. Adolescents with PHIV must contend with the negative effects of life-long viral
infection and chronic inflammation on their neurodevelopment, medical status, mental health, and, for many, the
demands of lifelong ART adherence – placing them at risk for not achieving these important milestones.
Neurocognitive impairment (NCI) is chief among these negative effects. NCI in adolescents with PHIV most
commonly affects the neurocognitive domains of working memory, executive function and processing speed, and
may be particularly vulnerable to NCI related to the prefrontal cortex, which plays a key role in cognitive flexibility,
response inhibition and attentional control (i.e., executive functioning). NCI can affect youth’s ability to perform in
and complete school, interact successfully with peers and adults, find employment, initiate and maintain long-
term relationships, and function independently. NCI can also interfere with adherence to medication, which is
critical in HIV, and increase poor decision-making and greater HIV transmission risk behaviors (e.g., unprotected
sex). The first step in addressing NCI adolescents with PHIV is detecting and diagnosing it, but doing so in South
Africa is seriously hampered. Few neurocognitive tests exist for the hundreds of thousands of youth with PHIV in
SA. The tests that do exist require highly trained personnel to administer and score, take several hours to
administer, lack ecological validity to predict real-world outcomes, and many suffer from cultural biases because
they were developed for and normed on youth in the US or Europe. Given how overburdened the SA healthcare
system is and its reliance on task-shifting various components of care to lay health workers (LHWs), without
accurate, clinically useful, and relatively brief neurocognitive tests that can detect NCI and meet the demands of
task-shifting in resource-limited settings, adolescents with PHIV in SA will not be assessed, missing opportunities
to detect NCI and intervene. This supplement will develop and add two new tests of executive functioning to the
NeuroScreen app that is being evaluated in the parent study (R01 HD095256; PI: Robbins), and will
strengthen our ability to detect executive functioning problems in youth with PHIV in SA – key neurocognitive
domains that may be particularly vulnerable in adolescents with PHIV and are highly related to academic,
behavioral and health outcomes.

## Key facts

- **NIH application ID:** 10094688
- **Project number:** 3R01HD095256-03S2
- **Recipient organization:** NEW YORK STATE PSYCHIATRIC INSTITUTE DBA RESEARCH FOUNDATION FOR MENTAL HYGIENE, INC
- **Principal Investigator:** Reuben N Robbins
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $353,645
- **Award type:** 3
- **Project period:** 2018-07-17 → 2021-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10094688

## Citation

> US National Institutes of Health, RePORTER application 10094688, Improving Assessment for Neurocognitive Impairment Among Older Adults with Alzheimer's Disease and Related Dementias (3R01HD095256-03S2). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10094688. Licensed CC0.

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