Neuropsychiatric aspects of HIV infection among older adults
Neuropsychiatric aspects of HIV infection among older adults
复制标题
DOI：
10.1016/s0895-4356(01)00446-2
复制
发表时间：
2001-12-01
影响因子：
7.2
通讯作者：
Goodkin, K
中科院分区：
文献类型：
--
作者：
Hinkin, CH;Castellon, SA;Goodkin, K
高效抗逆转录病毒疗法 (HAART) 等治疗技术的进步已转化为艾滋病毒感染者的预期寿命延长，这最终将导致艾滋病毒/艾滋病流行病的“灰色化”。此外，老年人的高频率行为的发生率比之前预期的要高。因此，对老年艾滋病毒感染者的研究，包括对该疾病的精神和神经认知方面的研究，似乎非常有必要。流行病学研究表明，与一般人群的基本发病率相比，艾滋病毒感染与多种心理/精神疾病的发病率较高有关。还有大量文献记录了艾滋病毒感染对年轻人的神经认知不良影响，从微妙的认知问题到明显的痴呆症。尽管有人假设年龄较大可能会加剧艾滋病毒感染的有害影响，但实际上人们对老年人中艾滋病毒相关精神和认知功能障碍的发病率、患病率、病程和临床特征知之甚少。本文概述了各年龄段艾滋病毒相关认知和精神疾病的流行病学和临床表现，特别关注年龄增长与艾滋病毒感染之间相互作用的已知情况。提出了未来的研究方向，包括对老年艾滋病毒感染者中神经疾病的发病率和患病率进行基础流行病学研究，以及旨在确定老年患者与年轻患者之间此类疾病的性质、严重程度、病程或治疗是否不同的调查。 (C) 2001 Elsevier Science Inc. 保留所有权利。
Treatment advances such as the advent of highly active antiretroviral therapy (HAART) have translated into greater life expectancy for HIV-infected individuals, which will ultimately result in a "graying" of the HIV/AIDS epidemic. In addition, older individuals are engaging in a higher rate of high fisk behaviors than had been previously expected. As such, study of older HIV-infected patients, including study of the psychiatric and neurocognitive aspects of the disease, appears highly indicated. Epidemiological studies have demonstrated that HIV infection is associated with higher rates of several psychological/psychiatric disorders when compared to general population base rates. There is also a rich literature that has documented the adverse neurocognitive effects of HIV infection, ranging from subtle cognitive complaints to frank dementia, among younger adults. Although it has been hypothesized that older age may potentiate the deleterious effects of HIV infection, little is actually known, however, regarding the incidence, prevalence, course, and clinical features of HIV-associated psychiatric and cognitive dysfunction among older adults. This article provides an overview of the epidemiology and clinical manifestations of HIV-associated cognitive and psychiatric disorder across the age spectrum, with particular focus on what is known regarding the interaction of advancing age and HIV infection. Future directions for research are suggested, including basic epidemiologic study of incidence and prevalence rates of neurodisease among older HIV-infected adults as well as investigations designed to determine whether the nature, severity, course, or treatment of such disorders differs among older versus younger patients. (C) 2001 Elsevier Science Inc. All rights reserved.