Everyday functioning (EF) impairment is frequent in people living with HIV (PLWH). Our aim was to better explore EF and its association with PLWH cognition, by administering both the IADL scale, the most common functional scale, and a new and ecologic multi-domain (communication and financial skills) tool to measure EF as the University of California San Diego (UCSD) Performance-Based Skills Assessment-Brief Version (UPSA-B). Eighty-five PLWH on cART with very good immunological condition and 23 age- and education-matched healthy controls (HC) were enrolled. PLWH underwent a standardized neuropsychological battery plus IADL, and cognitive impairment was defined according to Frascati criteria. Both groups underwent the UPSA-B. Only 6 subjects (7%) were affected by cognitive impairment (asymptomatic profile). While IADL score was at ceiling for all patients, the UPSA-B total score was significantly worse in PLWH when compared with HC [mean 82.1 (SD 9.3) vs 89.2 (SD 6.2); p < 0.001]. At communication subtest, PLWH group and HC were significantly different (p = 0.002), while no difference emerged at financial skills (p = 0.096). Higher score at UPSA-B was independently associated with better global cognitive performance (composite Z-score) (β 7.79; p < 0.001). Also considering each single cognitive domain, UPSA-B performance (both total and at subtests) confirmed the association with neurocognitive performance. In conclusion, UPSA-B seems to better discriminate EF impairment than IADL in PLWH, and it was associated with cognitive functions, also in the absence of symptomatic cognitive impairment. Thus, it appears a promising tool in the context of HIV infection to avoid misdiagnosis and to better detect also mild EF.

艾滋病病毒感染者 (PLWH) 的日常功能 (EF) 受损很常见。我们的目标是通过管理 IADL 量表（最常见的功能量表）和一种新的生态多领域（沟通和财务技能）工具来衡量 EF 的加利福尼亚大学，从而更好地探索 EF 及其与 PLWH 认知的关联圣地亚哥(UCSD) 基于绩效的技能评估 - 简要版本 (UPSA-B)。85 名在 cART 上免疫状况非常好的 PLWH 和 23 名年龄和教育匹配的健康对照 (HC) 被招募。PLWH 接受了标准化的神经心理学电池加 IADL，并且根据 Frascati 标准定义了认知障碍。两组均接受了UPSA-B。只有 6 名受试者 (7%) 受到认知障碍（无症状）的影响。虽然所有患者的 IADL 评分均处于上限，但与 HC 相比，PLWH 的 UPSA-B 总分明显更差 [平均 82.1 (SD 9.3) vs 89.2 (SD 6.2)；p  < 0.001]。在沟通子测试中，PLWH 组与 HC 有显着差异（p  = 0.002），而在财务技能方面没有出现差异（p = 0.096）。UPSA-B 的较高分数与较好的整体认知表现（复合 Z 分数）独立相关（β 7.79；p  < 0.001）。还考虑到每个单一的认知领域，UPSA-B 表现（总体和分测验）证实了与神经认知表现的关联。总之，在 PLWH 中，UPSA-B 似乎比 IADL 更好地区分 EF 损害，并且它与认知功能相关，在没有症状性认知损害的情况下也是如此。因此，在 HIV 感染的背景下，它似乎是一种很有前途的工具，可以避免误诊并更好地检测轻度 EF。