Dear Dr Horwath

I am a medical researcher at CSIR looking and cognition and depression in HIV positive workers. Is the modified HIV dementia scale a good screening tool for a non-neurologists (The Hopkins HIV report Vol 8 No. 4, November 1996). And what screening tool/questionnaire would you recommend for depression in a unskilled work force

Best wishes Belinda

Yes, the modified HIV dementia scale has been tested and compared to the original version. The modified version deletes the item on attention, which consists of testing antisaccadic eye movements, an item that most non-neurologists or otherwise untrained testers find difficult. The modified version results in a maximum score of 12 (as compared to 16 for the original). The comparisons suggest that the modified version is similarly reliable as a screening tool to pick up signs of dementia. It's important to remember that these scales are not sufficient by themselves to make a diagnosis of dementia. Clinical evidence of functional impairment is necessary to diagnose dementia.

As for depression, the Hamilton Depression scale and Beck depression scale are widely used in studies. A screening tool known as the PRIME-MD has been developed for use in general medical populations. Again, these scales by themselves are insufficient for a diagnosis, which requires an interview that puts the symptoms in context and inquires about the degree of functional impairment and other types of impact.