Infection used to be the main cause of dementia. Treatment for infections and inflammation of the central nervous system (CNS) has dramatically decreased the incidence of infection-related dementia. But there has been one infectious disease that has reversed the trend and that is HIV/AIDS. It is the statistical increase that is one of the few aspects in which HIV dementia can be compared to Alzheimer's. The big difference is that with Alzheimer's the increased incident of the disease is due to the increased longevity in developed nations. Better health care, decreased poverty, healthier lifestyles means we are living longer and age is the major risk factor for Alzheimer's.
Dementia due to HIV/AIDS
AIDS (acquired immune deficiency syndrome) is caused by the human immunodeficiency virus (HIV). It attacks the body's immune system making the person affected more susceptible to infection.
HIV-associated dementia has been described using a variety of terms. These include AIDS dementia complex (ADC), HIV encephalopathy, HIV-1-associated cognitive / motor complex, and encephalitis.
About one in five people with HIV infection show mild cognitive disorder. That is, mild impairments in activities of daily living, mild behavioral, motor and cognitive changes. Some have such mild symptoms that they are unaware of any changes or difficulties.
About 15 to 20 per cent of people with AIDS used to develop dementia. Now with improvements in combination anti-retroviral treatments in the USA and Europe, this has probably now halved.
Treatment for AIDS Dementia
Drugs have been developed that can treat the causes of the disease that lead to dementia. Although the anti- HIV drugs do not cure HIV or AIDS they can improve lifestyle and life expectancy. People with HIV-related cognitive impairment are usually prescribed a combination of anti-HIV treatments to stop or slow down the ability of HIV to cross into the brain, and to reduce the amount of HIV causing damage inside the brain. HIV-related cognitive impairment can be reversed if treated early.
As in Alzheimer's, drugs can be used to treat psychiatric and behavioral symptoms. These include:
Antidepressants, such as Zoloft, Lexapro, Wellbutrin and Effexor, which can help improve mood and counter apathy.
Neuroleptics, such as olanzepine and risperidone can be used to help with agitation and hallucinations.
As with Alzheimer's, rehabilitation to encourage life and activity skills is also very important.
National and local support agencies such as the Alzheimer's Organization and voluntary AIDS organizations as well as health care providers can provide invaluable help and advice. OurAlzheimer's at HealthCentral.com also provides help with caregiver advice and support
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