HIV and AIDS in Older Adults: Neuropsychiatric Changes

Purpose of Review Patients diagnosed with HIV can now survive well into their old age. Aging with HIV is not only associated with comorbid medical illnesses but also with neuropsychiatric conditions that can range from cognitive changes to severe behavioral manifestations. This paper reviews mood, anxiety, and cognitive changes in older patients with HIV, as well as some of the treatment challenges in this population. Recent Findings Most recent findings show that untreated HIV illness over a long period of time may further worsen both preexisting neuropsychiatric illness and may cause new onset behavioral and cognitive symptoms. HIV induces immune phenotypic changes that have been compared to accelerated aging Low CD 4 counts and high viral counts are indicative of poor prognosis. Summary Evaluation for potential HIV infections may be overlooked in older adults and require screening. Older adults experience accelerated CD4 cell loss. Older adults endorsing new onset mood or cognitive changes must be screened for HIV infection. New onset neurobehavioral symptoms should be carefully screened for and treated simultaneously in patients with HIV infection.

Automated summary

The purpose of this review is to explore the mood, anxiety, and cognitive changes in older HIV patients, as well as the challenges in their treatment. Recent findings suggest that untreated HIV illness may worsen preexisting neuropsychiatric disorders and cause new behavioral and cognitive symptoms. It is important to screen for potential HIV infections in older adults and to consider HIV as a possible cause for new-onset mood and cognitive changes. Neurobehavioral symptoms should be carefully screened and treated in patients with HIV infection.