Dementia
Dementia is a term used to describe a number of conditions, often associated with ageing, that lead to a progressive decline in a person’s ability to function independently. Dementia may affect a person’s memory, ability to plan and carry out tasks, and lead to behavioural changes. This can lead to difficulties with social interactions, working, and living independently. Dementia is not a normal part of ageing.
Importance for PLHIV50+
There are multiple types of dementia, that can affect anyone, including people living with HIV (PLHIV). However, PLHIV are also susceptible to HIV-associated neurocognitive disorder (HAND), though this is less common in people on antiretroviral therapy. HAND is sometimes referred to as HIV-Associated Dementia.
Dementia is common and affects approximately half a million Australian adults, though this number is expected to increase as the general population ages. Dementia is also a growing cause of death and disability, with the most common form of dementia being Alzheimer’s Disease. The risk of dementia increases with age, and is uncommon in people under the age of 65.
Sometimes, it can be associated with genetics, and run in families, but most of the time, dementia is not inherited. Other risk factors for dementia include smoking, high blood pressure, diabetes, and head trauma. Additional risk factors associated with cognitive impairment in PLHIV50+ include having a detectable viral load, low CD4 count, and some infections, including syphilis.
Symptoms
The symptoms of dementia can be subtle and often worsen over time. Signs and symptoms might include progressive memory loss, confusion, getting lost in familiar places, behavioural changes, difficulty speaking or writing, social withdrawal, and a loss of ability to perform routine daily tasks (e.g. banking, paying bills, driving, cooking).
Speak with your healthcare provider if you are worried that you or someone you care about might have dementia. There are a number of conditions that can mimic dementia, including hormone and vitamin deficiencies, mental health and other physical illnesses, which when treated can improve the symptoms of concern. Early assessment is helpful, and allows a person to plan ahead.
Diagnosis
Diagnosing dementia can be challenging, and can take some time. Healthcare providers will typically try to gather information from interacting with the person thought to be affected, and speaking with people they know, including family members and/or loved ones. A thorough assessment is important. Often, your healthcare provider will perform memory tests, and may refer you to a specialist for an opinion. Other tests may include blood tests, and imaging of the brain by either MRI or CT scan. Sometimes a lumbar puncture is needed, especially when HAND is suspected.
There is no cure or universal treatment for dementia, but medications are available that may help to manage some of the symptoms. Importantly, there are a number of practical things that can be done to maximise the independence of and enhance the quality of life for people with dementia. Planning ahead can ensure your priorities are known, and provide peace of mind for you and your loved ones into the future.