A Review of the Literature on Hiv and Neuropsychological Functioning in Older Adults: Is More Research Needed?

Abstract

The increase in the number of ageing people living with HIV and the documented neurocognitive impairments have highlighted the need to illuminate the existing findings and evaluate the impact that HIV has on older individuals. A review of the evidence for neuropsychological declines in memory, executive functions, attention and language in people aged 60 years or more was conducted. The databases MEDLINE, PsychINFO and Pubmed were searched for eligible studies based on keywords. Eight studies of low to high quality that looked at HIV+ older adults (≥ 60) were identified. The majority of older HIV+ adults experienced severe declines in all the cognitive domains under study. There were mixed results regarding the association among advancing age, functioning decline and HIV. Comparisons between HIV-infected and HIV-uninfected older adults showed that HIV+ subjects demonstrate higher scores of cognitive decline in memory, attention, language and executive functions. Further, comparisons among HIV+ adults, demographically matched individuals with mild cognitive impairment of the Alzheimer's type and healthy controls demonstrated that both disease groups perform worse, but the Alzheimer’s type group reports a greater decline in memory and language. Neuropsychological functioning in HIV+ adults presents great decline but studies on this population are limited. As individuals with HIV are increasingly living longer, studies should pay attention to these individuals and examine predictors of neuropsychological decline in the face of well-controlled interventions and treatments. Keywords: HIV, memory, neuropsychological function, executive functions, older adults