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Frequency and risk factors for HIV-associated neurocognitive disorder and depression in older individuals with HIV in northeastern Brazil

Published online by Cambridge University Press:  22 May 2012

Sérgio Murilo Maciel Fernandes Filho  and
Heloísa Ramos Lacerda de Melo
Sérgio Murilo Maciel Fernandes Filho*
Affiliation:
Postgraduate Program in Health Sciences, Universidade Federal de Pernambuco, Recife, Pernambuco, Brazil Hospital Getulio Vargas, Recife, Pernambuco, Brazil
Heloísa Ramos Lacerda de Melo
Affiliation:
Postgraduate Program in Health Sciences, Universidade Federal de Pernambuco, Recife, Pernambuco, Brazil Postgraduate Program in Tropical Medicine, Universidade Federal de Pernambuco, Recife, Pernambuco, Brazil
*
Correspondence should be addressed to: Sérgio Murilo Maciel Fernandes Filho, Hospital Getúlio Vargas, Avenida General San Martin, S/N. CEP: 50630-060 Recife, PE, Brazil. Phone: +55 81 31845861; Fax: +55 81 31845861. Email: [email protected].
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Abstract

Background: The study was undertaken to describe the frequency of HIV-associated neurocognitive disorders (HAND) and depressive symptoms in an older population with human immunodeficiency virus (HIV).

Methods: A cross-sectional analysis of patients aged 50 years or older infected with HIV was carried out in an outpatient setting in Brazil from March to November 2008. Patients selected were submitted to cognitive evaluation using the Mini-Mental State Examination and International HIV Dementia Scale, and also to functional and depression evaluations.

Results: Among the 52 patients evaluated, the frequency of neurocognitive disorder was 36.5%, while for dementia the frequency was 13.5%. No risk factors were identified. Among the patients with cognitive impairment, 73.7% had cortical impairment. The frequency of depressive symptoms was of 34.6%. The female gender was identified as a risk factor (p = 0.018) and patients with depressive symptoms had greater functional impairment (p < 0.001).

Conclusion: HAND and depressive symptoms are common in an older population. Patients with cognitive impairment achieved lower scores on the cortical assessment scales. Depressive symptoms are a stronger factor for functional impairment.

Keywords

AIDS dementia complexHIV infectiondementiaaged
Type
Research Article
Information
International Psychogeriatrics , Volume 24 , Issue 10 , October 2012 , pp. 1648 - 1655
Copyright
Copyright © International Psychogeriatric Association 2012

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References

Albert, S. M. et al. (1995). Neuropsychologic impairment in early HIV infection: a risk for work disability. Archives of Neurology, 52, 525–530.CrossRefGoogle ScholarPubMed
Almeida, O. P. (1998). The Mini-Mental State Examination and the diagnosis of dementia in Brazil. Arquivos de Neuropsiquiatria, 56, 605–612.CrossRefGoogle ScholarPubMed
Almeida, O. P. and Almeida, S. A. (1999). Reliability of the Brazilian version of the Geriatric Depression Scale (GDS) short form. Arquivos de Neuropsiquiatria, 57, 421–426.CrossRefGoogle ScholarPubMed
Antinori, A. et al. (2007). Updated research nosology for HIV-associated neurocognitive disorders. Neurology, 69, 1789–1799.CrossRefGoogle ScholarPubMed
Becker, J. T., Lopez, O. L., Dew, M. A. and Aizenstein, H. J. (2004). Prevalence of cognitive disorders differs as a function of age in HIV virus infection. AIDS, 18, S11–S18.CrossRefGoogle ScholarPubMed
Berg, C. J., Michelson, S. E. and Safren, S. A. (2007). Behavioral aspects of HIV care: adherence, depression, substance use, and HIV-transmission behaviors. Infectious Disease Clinics of North America, 21, 181–200.CrossRefGoogle ScholarPubMed
Brew, B. J. (1999). AIDS dementia complex. Neurologic Clinics, 17, 861–881.CrossRefGoogle ScholarPubMed
Dore, G. J., Correll, P. K., Li, Y., Kaldor, J. M., Cooper, D. A. and Brew, B. J. (1999). Changes to AIDS dementia complex in the era of highly active antiretroviral therapy. AIDS, 13, 1249–1253.CrossRefGoogle ScholarPubMed
Dore, G. J., McDonald, A., Yueming, L., Kaldor, J. M. and Brew, B. J. (2003). Marked improvement in survival following AIDS dementia complex in the era of highly active antiretroviral therapy. AIDS, 17, 1539–1545.CrossRefGoogle ScholarPubMed
Gifford, A. L., Bormann, J. E., Shively, M. J., Wright, B. C., Richman, D. D. and Bozzette, S. A. (2000). Predictors of self-reported adherence and plasma HIV concentrations in patients on multidrug antiretroviral regimens. Journal of Acquired Immune Deficiency Syndromes, 23, 386–395.CrossRefGoogle ScholarPubMed
Hinkin, C. H., Castellon, S. A., Durvasula, R. S., Lam, M. N. and Stefaniak, M. (2002). Medication adherence among HIV+ adults: effects of cognitive dysfunction and regimen complexity. Neurology, 59, 1944–1950.CrossRefGoogle ScholarPubMed
Janssen, R. S., Nwanyanwu, O. C., Selik, R. M. and Stehr-Green, J. K. (1992). Epidemiology of human immunodeficiency virus encephalopathy in the United States (Abstract). Neurology, 42, 1472–1476.CrossRefGoogle Scholar
Lochet, P., Peyrière, H., Lotthé, A., Mauboussin, J. M., Delmas, B. and Reynes, J. (2003). Long-term assessment of neuropsychiatric adverse reactions associated with efavirenz. HIV Medicine, 4, 62–66.CrossRefGoogle ScholarPubMed
Luther, V. P. and Wilkin, A. M. (2007). HIV infection in older adults. Clinics in Geriatric Medicine, 23, 567–583.CrossRefGoogle ScholarPubMed
McArthur, J. C. et al. (1993). Dementia in AIDS patients – incidence and risk factors: multicenter AIDS Cohort Study (Abstract). Neurology, 43, 2245–2252.CrossRefGoogle Scholar
McArthur, J. C., Brew, B. J. and Nath, A. (2005). Neurological complications of HIV infection. Lancet Neurology, 4, 543–555.CrossRefGoogle ScholarPubMed
Neurology AIDS Task Force (1991). Nomenclature and research case definitions for neurologic manifestations of human immunodeficiency virus-type 1 (HIV-1) infection. Neurology, 41, 778–785.CrossRefGoogle Scholar
Oliveira, J. F., Greco, D. B., Oliveira, G. C., Christo, P. P., Guimarães, M. D. C. and Corrêa-Oliveira, R. (2006). Neurological disease in HIV-infected patients in the era of highly active antiretroviral treatment: a Brazilian experience. Revista da Sociedade Brasileira de Medicina Tropical, 39, 146–151.CrossRefGoogle ScholarPubMed
Paradela, E. M. P., Lourenço, R. A. and Veras, R. P. (2005). Validation of Geriatric Depression Scale in a general outpatient clinic. Revista de Saúde Pública, 39, 918–923.CrossRefGoogle Scholar
Portegies, P. et al. (1993). Presentation and course of AIDS dementia complex: 10 years of follow-up in Amsterdam, The Netherlands (Abstract). AIDS, 7, 669–675.CrossRefGoogle Scholar
Rabkin, J. G., Elhiney, M. C. and Ferrando, S. J. (2004). Mood and substance abuse disorders in older adults with HIV/AIDS: methodological issues and preliminary evidence. AIDS, 18, S43–S48.CrossRefGoogle ScholarPubMed
Sacktor, N. C. et al. (2005). The International HIV Dementia Scale: a new rapid screening for HIV dementia. AIDS, 68, 1481–1487.Google Scholar
Schifitto, G. et al. (2001). Clinical trials in HIV-asssociated cognitive impairment: cognitive and functional outcomes. Neurology, 56, 415–418.CrossRefGoogle ScholarPubMed
Valcour, V. and Paul, R. (2006). HIV infection and dementia in older adults. Clinical Infectious Diseases, 42, 1449–1454.Google ScholarPubMed
Valcour, V. et al. (2004). Higher frequency of dementia in older HIV-1 individuals: the Hawaii aging with HIV-1 cohort. Neurology, 63, 822–827.CrossRefGoogle ScholarPubMed
Valcour, V. G., Shikuma, C. M., Watters, M. R. and Sacktor, N. C. (2004). Cognitive impairment in older HIV-1-seropositive individuals: prevalence and potential mechanisms. AIDS, 18, S79–S86.CrossRefGoogle ScholarPubMed
Wong, M. H. et al. (2007). Frequency and risk factors for HIV dementia in an HIV clinic in Sub-Saharan Africa. Neurology, 68, 350–355.CrossRefGoogle Scholar
Wright, E. et al. (2008). Neurologic disorders are prevalent in HIV-positive outpatients in the Asia-Pacific region. Neurology, 71, 50–56.CrossRefGoogle ScholarPubMed