Preliminary Study Results Demonstrate Mental Impairment in Older Patients With HIV
Preliminary results from a continuing South Florida study of HIV and mental impairment demonstrate that people over the age of 50 with HIV have significant impairment with symptom levels approaching almost twice that of younger patients, the Miami Herald reports. Dr. Karl Goodkin, a University of Miami psychiatrist, and colleagues in 1998 received a $1.8 million NIH grant to compare mental impairment among people with HIV. The researchers began enrolling participants of all ages with all stages of the disease; 196 of the 286 participant spots have been filled so far. Participants undergo standard physical and mental tests during their three-year enrollment. Their response to visual stimuli is recorded, and they are medically evaluated for six symptoms related to memory and movement problems, including impaired concentration, slowed movement, irritability and "hobbled" coordination. Blood samples are also drawn to analyze immune system damage.
Preliminary Results 'Striking'
Preliminary results are "striking," with patients over the age of 50 exhibiting nearly twice the level of symptoms of mental impairment as younger patients, the Herald reports. Blood analysis also showed that older patients sustained the most damage to immune cells. Researchers have long known that advanced HIV can cause AIDS dementia, but this study found impairment in people without other signs of AIDS. "It just takes them longer to do mental tasks. For example, it takes longer to read a newspaper article. They're used to remembering it without referring back to the article. They find they have to refer back to the article a lot earlier when these symptoms first start showing up," Goodkin said. The results are especially important as more people with HIV are living into middle age due to treatment advances. In 1999, people over the age of 50 accounted for 13.4% of new AIDS cases, compared to 9.7% of new cases in 1993. Although AIDS drugs have successfully prolonged the lives of many patients, some of the drugs cannot penetrate brain tissue, allowing the virus in the brain to go unchecked and possibly mount a rebound attack. Goodkin recommends that doctors perform "detailed" examinations of patients' brains to detect HIV reservoirs and that doctors and counselors be aware of and inquire about HIV patients' mental condition. "Doctors are more geared to the physical aspects and managing the side effects than the memory. It's not typically something the physician asks: Are you having problems with your memory?" Sheri Kaplan, executive director of an AIDS counseling center in North Miami, said (Smith, Miami Herald, 1/20).