Assessing and treating forgetfulness and cognitive problems in adults with HIV

David E Vance, Pariya L Fazeli, Linda Moneyham, Norman L Keltner, James L Raper, David E Vance, Pariya L Fazeli, Linda Moneyham, Norman L Keltner, James L Raper

Abstract

In addition to the immune system, HIV affects the nervous system and the brain, producing neurological sequelae, often resulting in forgetfulness and cognitive problems. These problems can compromise medication adherence, interfere with instrumental activities of daily living such as driving and managing finances, increase dependency, and decrease quality of life. Cognitive problems emerge due to a variety of reasons; likewise, several evidence-based methods to mitigate causes and compensate for cognitive problems can be used alone or in combination. This article focuses on nonpathological, nondementia forgetfulness and cognitive problems. However, dementia must be considered and assessed as measured by marked cognitive decline over time. Methods for assessing and measuring forgetfulness and cognitive problems are provided. In addition, methods of treating nonpathological cognitive problems are provided, ranging from Recommended for Practice to Not Recommended for Practice. A case study is presented to demonstrate how to implement recommended treatment options.

Conflict of interest statement

Conflict of Interest Statement/Acknowledgement

No other authors have a conflict of interest.

Copyright © 2013 Association of Nurses in AIDS Care. Published by Elsevier Inc. All rights reserved.

Figures

Figure 1
Figure 1
Assessment flow chart. Reprinted with permission from SLACK Incorporated: Vance, D. E., Farr, K., & Struzick, T. C. (2008). Assessing the clinical value of cognitive appraisal in adults aging with HIV. Journal of Gerontological Nursing, 34(1), 36–41. doi:10.3928/00989134-20080101-11 Note. IADLS = Instrumental activities of daily living.
Figure 2
Figure 2
Montreal cognitive assessment. Copyright Z. Nasreddine, MD. Reproduced with permission. Copies are available at www.mocatest.org
Figure 3
Figure 3
Factors that positively or negatively affect cognitive reserve.
Figure 4
Figure 4
Co-morbidities, treatment, and lifestyle factors affect cognition over time. Note. ART = antiretroviral therapy.

Source: PubMed

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