HIV-associated dementia in older adults: clinical and tomographic aspects
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2011
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Background: Elderly adults with human immunodeficiency virus (HIV) are at greater risk of developing
cognitive impairment. The purpose of this study was to describe clinical and tomographic characteristics
of HIV-1 associated dementia (HIVD) in older adults.
Methods: A descriptive study was carried out involving eight HIVD patients. Seven tests were employed for
cognitive assessment and transformed to whole number z-scores using appropriate normative sets.
Results: The average age of the patients was 71 years; seven cases described the route of HIV infection as
being heterosexual; and mean schooling was 6.5 years. Six subjects were using highly active anti-retroviral
therapy (HAART), with an average CD4 count of 407.8 cells/mm3. Mild dementia was detected in most
cases (87.5%). Deficits on neuropsychological tests showed results similar to multi-center transversal studies
on HIVD. The classic HIVD triad observed in younger adults was also seen in this population: i.e. cognitive
changes, psychiatric changes and motor impairment. Cortical injury shown by dyscalculia, visual-spatial
change and language deficits were frequent. Brain images showed cortical atrophy in all patients but was
restricted to frontal lobes in five cases.
Conclusion: The findings on brain imaging were non-specific, revealing images similar to those of the elderly
brain and to HIVD in younger adults. HIVD in the elderly is a challenge and become an increasingly significant
differential diagnosis for cognitive loss in old age. This dementia must be clinically suspected and image exams
are useful in excluding other central disorders. Prospective studies of HIV-positive elderly people are warranted
to better understand HIVD.
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HIV, Cognitive impairment, Brain imaging
Citação
SILVA, Emanuela Torreão Brito e et al. HIV-associated dementia in older adults: clinical and tomographic aspects. International Psychogeriatrics, New York, v. 23, n. 7, p. 1061-1069, 2011. DOI: 10.1017/S1041610210002474. Disponível em: https://www.sciencedirect.com/science/article/pii/S1041610224022154. Acesso em: 27 jan. 2025.