KEEPING ALL YOUR MARBLES
By: Vivienne Walz
Supervision and Translation by: Gilbert Mallais June 28, 2012
In the last 15 years, treatment for HIV/AIDS has come a long way. More HIV+ adults are now living into their fifties, sixties and beyond; but with this new demographic of PHAs, comes some new challenges. Among these are serious non-AIDS related events (or SNAREs). SNAREs are linked with a low nadir (the lowest CD4 cell count ever had by a PHA), and are becoming increasingly common, as HIV+ patients are getting older.
One particular SNARE is HIV-associated dementia. Dementia is often used as a blanket term for neurocognitive impairments associated with aging. Typical symptoms of dementia include new memory impairments accompanied by language, movement-planning, learning and recognition inabilities that interfere with daily life. Alzheimer disease is one type of dementia. Another is AIDS dementia complex.
Good news: in the case of AIDS dementia complex, one’s condition can actually improve with HAART.
More good news: there are many controllable risk factors associated with cognitive decline. Consistently continuing with antiretroviral therapy is one way to reduce the risk of cognitive decline later in life. Avoiding STIs and aiming for a CD4 count of greater than 500 are also important. Large waist circumference has also been linked to development of dementia, so by eating right and exercising the risk can be decreased. Being active has the added benefit of improving cardiovascular fitness, which also helps prevent cognitive decline. By eating healthy the risk of
developing type II diabetes, which is associated with cognitive decline among HIV+ patients, is also lowered. Taking care of mental health is important too, by treating depression and maintaining social stimulation.
SNAREs like HIV-associated dementia are a new challenge that aging PHAs are facing. But by taking care of the body and the soul, the mind can be protected.
Source: Julian Falutz, MD. “HIV, Aging and Cognition: Current Status and Future Challenges – Maintaining and Improving Cognitive Function”. June 2010.