HIV, Aging, and the Risk of Dementia in Men

It is understood that individuals who are HIV positive experience other chronic and age-related diseases. Dementia, a term used to describe chronic memory loss which can be caused by brain disease, has been found to have an association with aging men who are HIV positive.

Being aware of the associated risk can help physicians determine and address the diagnosis at an earlier stage to treat a patient accordingly.

Risk of dementia

A recent study (published in the journal AIDS) has shown that even while taking antiretroviral therapy (ART), HIV can impact the brain and cause modifications in cognitive activity.

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In addition, it is known that some antiretroviral therapy drugs have side effects that may cause illnesses that affect the brain. As a result, the possible side effects one may experience increases the risk of dementia.

A study on HIV & dementia in men

Using data during 2005-2015, the study examined 1,114 veterans who are HIV positive, of at least 55 years of age, and diagnosed with dementia.1 Results were compared to 1,114 HIV-negative veterans within the same age, race, sex, and substance abuse history.1

Who was part of the study?

The average age of participants was 62.5 years, 38 percent identified as non-Hispanic Black, and 52 percent identified as non-Hispanic White.1 Both comparison groups were matched well to demonstrate similar variables as it pertains to health history and current drug/alcohol use. “However, the baseline rate of depression was significantly higher among veterans with HIV, who were also more likely to be better educated but tended to have a lower income.”1

Antiretroviral therapy & risk factors

61 percent of veterans who were HIV positive received antiretroviral therapy.1 Those who did use antiretroviral therapy also exhibited worse risk factors.

For example, 18.4 percent of veterans who were not on antiretroviral therapy experienced depression; whereas, 26.2 percent of those on antiretroviral therapy did experience depression.1 In addition, 14.7 percent of those not on antiretroviral therapy used drugs and/or alcohol in comparison to 21.8 percent of those on antiretroviral therapy who did.1

The study also outlines that veterans living with HIV who took antiretroviral therapy demonstrated a considerably higher risk of being diagnosed with dementia contrasted with those veterans not using antiretroviral therapy.1

The role of HIV in dementia diagnosis

Researchers, still, however, studied the role of HIV being a potential risk factor for dementia alone. They also found that the severity of one’s disease drove the differences in risk pertaining to antiretroviral therapy.1 The group on antiretroviral medication presented a lower CD4 count at the time of being diagnosed with dementia.1 It has been suggested that veterans who were the sickest most likely received the antiretroviral medication.

Why is this research important?

Previous research focused primarily on HIV-associated dementia (without the usage of antiretroviral medication). Today, due to the wide availability of antiretroviral medications, it is not as common.

As a result of the research’s findings, it is not very clear why antiretroviral therapy causes an increased risk of dementia to occur. But, it is apparent that there is a strong association between having HIV and a dementia diagnosis.1

Further research will help narrow down and specifically understand by which mechanism the increased risk arises. Additionally, the increased findings will continue to benefit successful treatment among aging men with HIV.

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