Reasons for HIV-associated dementia in an older adult:
(1) prolonged survival of HIV-positive patients with HAART
(2) Viagra and other medications that improve male sexual function
The HIV-associated dementia may occur by itself but often is mixed with:
(1) vascular dementia (diabetes mellitus, stroke, etc)
(2) Alzheimer's disease
(3) alcohol-related cognitive impairment
(4) medication-related cognitive impairment
(5) nutritional disorders
(6) other neurocognitivie disorders
An elderly patient with HIV-associated dementia may experience problems in:
(1) verbal learning
(2) memory
(3) motor impairment
(4) psychiatric changes
(5) impaired attention
The diagnosis may be difficult:
(1) if HIV testing is not performed
(2) for an older woman married to a man with secret risk factors for HIV infection
(3) if risk factors for HIV infection are not disclosed or asked about
(4) if the patient already has a diagnosis that can explain dementia
Reasons to suspect the diagnosis:
(1) onset of opportunistic infections or other AIDS-defining condition
(2) disclosure of risk factors for an HIV infection
(3) exclusion of other causes or inconsistencies in the clinical data
(4) workup of unexplained lymphopenia
