A new study reveals that Malawians living with HIV are more than twice as likely to develop dementia compared to those without HIV. With the rising life expectancy due to better HIV treatments, this puts a greater focus on healthcare challenges, as aging populations face emerging risks for dementia. The research underscores the urgency in developing dementia management resources in resource-poor regions like Malawi.
A recent study conducted by US and Malawian researchers has revealed that adults with HIV in Malawi are over twice as likely to suffer from dementia than those without the virus. Published in the journal Alzheimer’s and Dementia, this research highlights the substantial burden of dementia on individuals living with HIV in Malawi, emphasizing the necessity of examining dementia within resource-limited contexts with inadequate healthcare access.
With advancements in antiretroviral therapy facilitating longer lives for people living with HIV, various health challenges arise. Not only does HIV increase the risk for diseases typically associated with aging, such as diabetes and heart disease, but it also elevates the likelihood of dementia due to inflammation and other brain changes.
In Malawi, where approximately 8 to 12 percent of adults are HIV positive and where HIV remains the primary cause of mortality, life expectancy has significantly improved. The World Health Organization indicates that children born in 2000 had a life expectancy of 45 years, while those born in 2021 are expected to live until 63, indicating a demographic shift that may lead to increased dementia cases in aging populations across sub-Saharan Africa.
Study lead author Haeok Lee, a professor at NYU Rory Meyers College of Nursing, expressed concern about the existing gap in dementia research focused on low- and middle-income countries compared to high-income countries, where much of the current knowledge originates.
The research involved analyzing medical records from 400 adult patients aged 30 and older at an outpatient clinic in Lilongwe. Half of the participants were HIV-positive and receiving antiretroviral therapy, while the other half were not infected. Results indicated that 22 percent of individuals with HIV had dementia, in contrast to 10 percent of those without the virus, with a more rapid increase in dementia cases observed among the HIV positive group as they aged.
Both older age and depression emerged as significant risk factors for dementia in individuals with and without HIV. Additionally, for those living with HIV, job instability correlated with an increased risk of developing dementia.
The researchers acknowledged limitations in relying on medical records for assessing dementia in Malawi, such as the difficulties associated with analyzing paper charts, absence of standardized diagnostic codes, and lack of data regarding substance use. Furthermore, with a dearth of healthcare professionals, including only one neurologist available for the adult population, accurate diagnoses of dementia are likely insufficient due to inadequate screening practices.
Study author Jonathan Ngoma remarked, “We need to do more in order for us to look after patients with dementia in low- and middle-income countries.” He emphasized the importance of raising awareness and accumulating valuable data. Lee stressed the urgent need for developing appropriate infrastructure to manage dementia among both HIV-positive individuals and the general population, recommending customized cognitive assessment tools and treatment guidelines that reflect the local health system.
The study sheds light on the heightened risk of dementia among individuals living with HIV in Malawi, indicating a pressing need for targeted research and patient management strategies in low-resource settings. Given the expected increase in dementia cases due to a growing aging population and lingering challenges in healthcare access, cultivating effective management practices and diagnostics specific to the region is essential. The efforts of the researchers highlight the importance of addressing these healthcare issues in both HIV and dementia, aiming to improve outcomes in Malawi.
Original Source: www.nyu.edu
