Neuropsychological testing

All participants underwent a battery of neuropsychological assessments (Table 2), with raw scores for each participant being converted to demographically-adjusted z-scores using published normative data [75–77]. This battery, which was developed in collaboration with a clinical neuropsychologist specializing in cognitive disorders, assessed multiple functional domains known to be impaired in patients with HAND and those on the AD spectrum. Specifically, the cohort of PWH were assessed on the following cognitive domains per the Frascati criteria [68] learning, memory, attention and executive function, motor, and processing speed. The ADS cohort completed a neuropsychological assessment that assessed commonly impaired cognitive domains in AD: learning, memory, attention and executive function, language, and processing speed. In addition, we measured premorbid function and functional impairment in all participants, along with general cognitive status in the AD group. Controls completed one of these two batteries depending on which project they were drawn from. Using these assessments and activities of daily living (ADL) [78], PWH were diagnosed with HAND according to the Frascati guidelines, including subgroups with asymptomatic neurocognitive impairment (ANI; 16 patients or 69.57% of final sample; i.e., having at least two cognitive domains one SD below the standardized mean with no functional declines), mild neurocognitive disorder (MND; two patients or 8.70% of final sample; i.e., at least two cognitive domains one SD below the standardized mean, with ADL deficits), or HIV-associated dementia (HAD; five patients or 21.74% of final sample; i.e., having at least two cognitive domains two SDs below the standardized mean, with ADL deficits). Healthy controls were cognitively normal and did not meet the above criteria for neuropsychological impairment. For patients on the ADS, instrumental activities of daily living (IADLs) were measured (with an informant) using the Functional Activities Questionnaire (FAQ) [79]. In addition to the neuropsychological battery, general cognitive status was measured using the Montreal Cognitive Assessment (MoCA) [80] and the Mini-Mental State Examination (MMSE) [81].

Mean demographically corrected z-scores and standard deviations of neuropsychological performance on the assessments included in each study battery by group. Assessments that are shared across both cohorts are in bold. PWH, People with HIV; ADS, Alzheimer’s disease spectrum; HVLT-R, Hopkins Verbal Learning Test – Revised; WMS-IV, Wechsler Memory Scale, 4^th Edition; WAIS-III, Wechsler Adult Intelligence Scale, 3^rd Edition; WAIS-IV, Wechsler Adult Intelligence Scale, 4^th Edition; WRAT-4, Wide Range Achievement Test.

¹z-score.

²Raw score.