OBJECTIVES: Ten per cent of all new cases of AIDS in the United States are in persons older than 50 years. This is particularly problematical in the case of the neuropsychiatric consequences of HIV, because there are neuropsychiatric disorders which become common in older individuals in the absence of HIV. The purpose of this report is to describe the prevalence and incidence of cognitive impairment in HIV-infected individuals enrolled in a community-based study. DESIGN: The study consisted of community-based, sentinel survey physician referrals of HIV-infected patients, with volunteer recruitment of risk-appropriate seronegative controls. One-year longitudinal follow-up study. METHODS: Detailed neuropsychiatric evaluations were performed at study entry and after one year. A brief, interim visit tracked incident change. Each subject's neuropsychological test performance was classified as normal, demented, or cognitive impairment (not demented). RESULTS: The prevalence of cognitive disorder among HIV-positive individuals over 50 years was significantly greater than in individuals younger than 50 years. Among older participants, dementia was the more common classification (23%), whereas among younger participants, a milder form of cognitive impairment was more prevalent (22%). Alcohol abuse/dependence was a significant risk factor for a disorder, whereas greater education was a protective factor. The one-year incidence of disorder in the sample overall was low (7.3%), and age was not a significant risk factor. However, HIV viral load at study entry was significantly higher among those participants who had developed cognitive impairment one year later. CONCLUSION: Age is a significant risk modifier for prevalent neuropsychological disorder.
OBJECTIVES: Ten per cent of all new cases of AIDS in the United States are in persons older than 50 years. This is particularly problematical in the case of the neuropsychiatric consequences of HIV, because there are neuropsychiatric disorders which become common in older individuals in the absence of HIV. The purpose of this report is to describe the prevalence and incidence of cognitive impairment in HIV-infected individuals enrolled in a community-based study. DESIGN: The study consisted of community-based, sentinel survey physician referrals of HIV-infectedpatients, with volunteer recruitment of risk-appropriate seronegative controls. One-year longitudinal follow-up study. METHODS: Detailed neuropsychiatric evaluations were performed at study entry and after one year. A brief, interim visit tracked incident change. Each subject's neuropsychological test performance was classified as normal, demented, or cognitive impairment (not demented). RESULTS: The prevalence of cognitive disorder among HIV-positive individuals over 50 years was significantly greater than in individuals younger than 50 years. Among older participants, dementia was the more common classification (23%), whereas among younger participants, a milder form of cognitive impairment was more prevalent (22%). Alcoholabuse/dependence was a significant risk factor for a disorder, whereas greater education was a protective factor. The one-year incidence of disorder in the sample overall was low (7.3%), and age was not a significant risk factor. However, HIV viral load at study entry was significantly higher among those participants who had developed cognitive impairment one year later. CONCLUSION: Age is a significant risk modifier for prevalent neuropsychological disorder.
Authors: Jose A Muñoz-Moreno; Carmina R Fumaz; Anna Prats; Maria J Ferrer; Eugènia Negredo; Núria Pérez-Alvarez; José Moltó; Guadalupe Gómez; Maite Garolera; Bonaventura Clotet Journal: J Neurovirol Date: 2010-05 Impact factor: 2.643
Authors: James T Becker; Melissa Fabrizio; Gustavo Sudre; Anna Haridis; Timothy Ambrose; Howard J Aizenstein; William Eddy; Oscar L Lopez; David A Wolk; Lauri Parkkonen; Anto Bagic Journal: J Neurosci Methods Date: 2012-03-05 Impact factor: 2.390
Authors: David J Moore; Miguel Arce; Suzanne Moseley; J Allen McCutchan; Jennifer Marquie-Beck; Donald R Franklin; Florin Vaida; Cristian L Achim; Justin McArthur; Susan Morgello; David M Simpson; Benjamin B Gelman; Ann C Collier; Christina M Marra; David B Clifford; Robert K Heaton; Igor Grant Journal: J Neuropsychiatry Clin Neurosci Date: 2011 Impact factor: 2.198
Authors: Andrew J Levine; Susan Service; Eric N Miller; Sandra M Reynolds; Elyse J Singer; Paul Shapshak; Eileen M Martin; Ned Sacktor; James T Becker; Lisa P Jacobson; Paul Thompson; Nelson Freimer Journal: Am J Med Genet B Neuropsychiatr Genet Date: 2012-05-24 Impact factor: 3.568
Authors: Andrew J Levine; Elyse J Singer; Janet S Sinsheimer; Charles H Hinkin; Jeanette Papp; Sugandha Dandekar; Allison Giovanelli; Paul Shapshak Journal: Neurobehav HIV Med Date: 2009-11