Adults living with HIV in Malawi are over twice as likely to have dementia compared to non-HIV individuals, according to a study by US and Malawian researchers. The increasing life expectancy of HIV patients brings challenges, as they face greater risks for age-related illnesses including dementia. The research highlights the need for more understanding and resources for dementia care in resource-limited settings.
A recent study conducted by researchers from the United States and Malawi reveals that adults living with HIV in Malawi face a significantly higher risk for dementia, being more than twice as likely to have the condition compared to those without HIV. The findings emphasize the critical need to investigate dementia in resource-limited settings, particularly where healthcare access is restricted.
The research, published in the journal “Alzheimer’s and Dementia,” highlights a troubling trend: as antiretroviral therapy extends the lifespan of those with HIV, they simultaneously encounter an increased risk for age-related illnesses, including dementia. The study illustrates that HIV-related inflammation may contribute to cognitive decline, thus raising the urgency for dementia research in this population.
In Malawi, where 8 to 12 percent of adults live with HIV, life expectancy has notably improved from an average of 45 years for children born in 2000 to an expected 63 years for those born in 2021, according to the World Health Organization. However, as Malawi’s population ages, experts warn of a potential increase in dementia cases in the future.
Professor Haeok Lee, the study’s lead author from NYU Rory Meyers College of Nursing, noted the disproportionate focus on dementia research from high-income countries, emphasizing the lack of understanding regarding dementia prevalence in low- and middle-income nations.
The researchers analyzed medical records from 400 adult patients aged 30 years and older at an outpatient clinic in Lilongwe, Malawi. Of the participants, 50% were HIV-positive and receiving antiretroviral therapy, while the other half were not infected. Results indicated that dementia was present in 22% of those with HIV compared to 10% among those without it, with a more rapid increase of dementia diagnoses among HIV-positive individuals as they aged.
Mental health factors also emerged as significant, with depression being a crucial dementia risk for both cohorts. Additionally, unstable employment appeared to escalate the risks for individuals living with HIV. The study acknowledges limitations in evaluating dementia prevalence due to factors such as reliance on paper medical records, lack of standardized diagnostic codes, and significant healthcare personnel shortages. The singular neurologist in Malawi likely contributes to underdiagnosis of dementia.
Jonathan Ngoma of Kamuzu Central Hospital expressed the need for further efforts to support dementia care in low- and middle-income settings, stating, “We have embarked on a journey to bring out a lot of information to the world.” Professor Lee further emphasized the necessity of building infrastructure to manage dementia, proposing the development of culturally relevant cognitive assessment tools and treatment guidelines tailored to the Malawian healthcare context.
The forthcoming study will be featured in a special issue of “Alzheimer’s and Dementia” dedicated to dementia research across Africa, aiming to advance the understanding of dementia in diverse populations.
In conclusion, this study illustrates the heightened risk of dementia among adults with HIV in Malawi, revealing an urgent need for tailored interventions and infrastructure to manage cognitive health in this population. The findings advocate for a broader focus on dementia research in low- and middle-income countries. Efforts must be intensified to provide adequate support and care for individuals suffering from dementia, particularly those living with HIV, within the local health context.
Original Source: www.nyu.edu
