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61/100

✓ Peer-reviewed alzhub usefulness score 61 out of 100. Getting a diagnosis

Topic: Risk, prevention and care in population studies

Plain-language summary

We determined incidence and future projections of dementia after AIDS onset in 492 homosexual men with AIDS in the Baltimore/Los Angeles sites of the Multicenter AIDS Cohort Study, 64 of whom developed dementia. We studied various risk factors for dementia, including demographic and clinical features, medical history, markers of immune status before AIDS, and zidovudine use. During the first 2 years after AIDS, HIV dementia developed at an annual rate of 7%. Overall, 15% of the cohort followed through death developed dementia. The median survival after dementia was 6.0 months. Using a proportional hazards model, risk factors for more rapid development of dementia were lower hemoglobin (relative hazard, 0.59 per additional 2 g/dl; p = 0.0005) and body mass index (relative hazard, 0.64 per additional 5 kg/m2; p = 0.05) 1 to 6 months before AIDS, more constitutional symptoms 7 to 12 months before AIDS (relative hazard, 1.68 per additional symptom, p = 0.005), and older age at AIDS onset (relative hazard, 1.60 per decade older; p = 0.009). In a multivariate model, pre-AIDS hemoglobin remained the most significant predictor of dementia. There were no significant risks defined from demographic characteristics, specific AIDS-defining illnesses, zidovudine use before AIDS, or CD4+ lymphocyte count before AIDS. We project that 12 months after the first AIDS diagnosis, 7.1% of survivors will have dementia. The observed association between anemia, low weight, constitutional symptoms, and dementia suggests a role for cytokines inducing both systemic and neurologic disease.

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APA 7th

McArthur, J. C., Hoover, D. R., Bacellar, H., Miller, E. N., Cohen, B. A., Becker, J. T., et al. (1993). Dementia in AIDS patients: incidence and risk factors. Multicenter AIDS Cohort Study. Neurology. https://doi.org/10.1212/wnl.43.11.2245

Vancouver

McArthur JC, Hoover DR, Bacellar H, Miller EN, Cohen BA, Becker JT, et al. Dementia in AIDS patients: incidence and risk factors. Multicenter AIDS Cohort Study. Neurology. 1993. doi:10.1212/wnl.43.11.2245. PMID: 8232937.

BibTeX

@article{mcarthur1993-8232937,
  author  = {McArthur, J. C. and Hoover, D. R. and Bacellar, H. and Miller, E. N. and Cohen, B. A. and Becker, J. T. and Graham, N. M. and McArthur, J. H. and others},
  title   = {{Dementia in AIDS patients: incidence and risk factors. Multicenter AIDS Cohort Study}},
  journal = {Neurology},
  year    = {1993},
  doi     = {10.1212/wnl.43.11.2245},
  pmid    = {8232937},
  url     = {https://doi.org/10.1212/wnl.43.11.2245}
}

Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. The record's author list ends in “et al.”, so not every author is named. Check the citation against the original before you use it.

How to read this study

Design: this is a follow-up (cohort) study. People are observed over time and not assigned to anything, so an association can reflect other differences between groups. Look at how long follow-up lasted, how many dropped out, and whether the authors adjusted for age, education and other health conditions.
Size: the record gives no participant count. Look for one in the original before trusting a pattern.
Effect: the record reports “7.1%”. A statistically significant result can still be small in daily life.

What the evidence grade means here

This page is graded moderate. alzhub.org assigns the grade automatically from keywords in the abstract, not from reading the paper. Moderate means the abstract mentions a cohort, case-control or longitudinal design. It can add at most 5 of the 100 points in the study score, and it is a label about design, not a verdict on whether the findings are true.

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Key findings

Overall, 15% of the cohort followed through death developed dementia.
In a multivariate model, pre-AIDS hemoglobin remained the most significant predictor of dementia.
There were no significant risks defined from demographic characteristics, specific AIDS-defining illnesses, zidovudine use before AIDS, or CD4+ lymphocyte count before AIDS.

Why it matters

In this cohort of men with AIDS, 15% developed dementia, with a median survival after dementia of 6.0 months. Lower pre-AIDS hemoglobin was the most significant predictor of dementia, while there were no significant risks defined from demographic characteristics, specific AIDS-defining illnesses, zidovudine use before AIDS, or CD4+ lymphocyte count before AIDS.

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Study details

Study designcohort study
Effect size7.1%
Evidence strengthModerate

How this study scored 61/100

Published in a leading specialty journal, and it is a cohort study following people over time. Scored zero for sample size, studied in people and randomized / blinded because the record does not state it.

Component	Points	Why
Journal tier	9 / 10	Tier 2 — leading specialty journal (Neurology)
Journal's citation record	4 / 4	Neurology: journal h-index 525 (OpenAlex, 2026-10-29)
Study design	7 / 12	A cohort study following people over time
Strength of evidence	3 / 5	Rated “moderate” in our summary
Peer-review validation	10 / 10	Peer-reviewed. Published as an article in a named peer-reviewed journal.
How recent	1 / 5	1993 — older than 20 years, still counted
Sample size	0 / 4	Participant count not stated — scores zero (not stated in the record — scored 0)
Effect reported	2 / 3	Effect reported as a number, without an interval or test
Studied in people	0 / 3	Not stated whether this was studied in people — scores zero (not stated in the record — scored 0)
Randomized / blinded	0 / 2	No randomization or blinding stated — scores zero (not stated in the record — scored 0)
Times cited	6 / 7	Cited 667 times (OpenAlex, 2026-10-10)
Citations per year	3 / 5	19.1 citations a year over 35 year(s) since 1993
Impact for its field and year	3 / 6	Cited 4.8× the average for papers of its field and year (OpenAlex FWCI)
Cited by studies here	3 / 6	Cited by 15 other studies in this library
Still being cited	1 / 4	Cited 14 times in 2024–2026 (2026 still in progress; OpenAlex)
Senior author's track record	3 / 4	Last-listed author Alfred J. Saah: h-index 69 (OpenAlex, whole career)
Institution's track record	2 / 3	Johns Hopkins University: institution h-index 2,306 (OpenAlex)
Multicenter collaboration	2 / 3	OpenAlex lists 4 institution(s) in 1 country
Indexed in PubMed	2 / 2	Indexed in PubMed (PMID 8232937)
Free to read	0 / 2	Behind a paywall — scores zero
Total	61 / 100	—

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