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Assessment and Management of HIV-Associated Cognitive Impairment: Experience from a Multidisciplinary Memory Service for People Living with HIV

As the HIV population ages, the prevalence of cognitive impairment (CI) is increasing, yet few services exist for the assessment and management of these individuals. Here we provide an initial description of a memory assessment service for people living with HIV and present data from a service evalu...

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Autores principales: Alford, Kate, Banerjee, Sube, Nixon, Eileen, O’Brien, Clara, Pounds, Olivia, Butler, Andrew, Elphick, Claire, Henshaw, Phillip, Anderson, Stuart, Vera, Jaime H.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6406482/
https://www.ncbi.nlm.nih.gov/pubmed/30744034
http://dx.doi.org/10.3390/brainsci9020037
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author Alford, Kate
Banerjee, Sube
Nixon, Eileen
O’Brien, Clara
Pounds, Olivia
Butler, Andrew
Elphick, Claire
Henshaw, Phillip
Anderson, Stuart
Vera, Jaime H.
author_facet Alford, Kate
Banerjee, Sube
Nixon, Eileen
O’Brien, Clara
Pounds, Olivia
Butler, Andrew
Elphick, Claire
Henshaw, Phillip
Anderson, Stuart
Vera, Jaime H.
author_sort Alford, Kate
collection PubMed
description As the HIV population ages, the prevalence of cognitive impairment (CI) is increasing, yet few services exist for the assessment and management of these individuals. Here we provide an initial description of a memory assessment service for people living with HIV and present data from a service evaluation undertaken in the clinic. We conducted an evaluation of the first 52 patients seen by the clinic. We present patient demographic data, assessment outcomes, diagnoses given and interventions delivered to those seen in the clinic. 41 patients (79%) of those seen in the clinic had objective CI: 16 (31%) met criteria for HIV-associated Neurocognitive Disorder (HAND), 2 (4%) were diagnosed with dementia, 14 (27%) showed CI associated with mental illness and/or drugs/alcohol, 7 (13%) had CI which was attributed to factors other than HIV and in 2 (4%) patients the cause remains unclear. 32 (62%) patients showed some abnormality on Magnetic Resonance Imaging (MRI) brain scans. Patients attending the clinic performed significantly worse than normative scores on all tests of global cognition and executive function. Interventions offered to patients included combination antiretroviral therapy modification, signposting to other services, case management, further health investigations and in-clinic advice. Our experience suggests that the need exists for specialist HIV memory services and that such a model of working can be successfully implemented into HIV patient care. Further work is needed on referral criteria and pathways. Diagnostic processes and treatment offered needs to consider and address the multifactorial aetiology of CI in HIV and this is essential for effective assessment and management.
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spelling pubmed-64064822019-03-13 Assessment and Management of HIV-Associated Cognitive Impairment: Experience from a Multidisciplinary Memory Service for People Living with HIV Alford, Kate Banerjee, Sube Nixon, Eileen O’Brien, Clara Pounds, Olivia Butler, Andrew Elphick, Claire Henshaw, Phillip Anderson, Stuart Vera, Jaime H. Brain Sci Article As the HIV population ages, the prevalence of cognitive impairment (CI) is increasing, yet few services exist for the assessment and management of these individuals. Here we provide an initial description of a memory assessment service for people living with HIV and present data from a service evaluation undertaken in the clinic. We conducted an evaluation of the first 52 patients seen by the clinic. We present patient demographic data, assessment outcomes, diagnoses given and interventions delivered to those seen in the clinic. 41 patients (79%) of those seen in the clinic had objective CI: 16 (31%) met criteria for HIV-associated Neurocognitive Disorder (HAND), 2 (4%) were diagnosed with dementia, 14 (27%) showed CI associated with mental illness and/or drugs/alcohol, 7 (13%) had CI which was attributed to factors other than HIV and in 2 (4%) patients the cause remains unclear. 32 (62%) patients showed some abnormality on Magnetic Resonance Imaging (MRI) brain scans. Patients attending the clinic performed significantly worse than normative scores on all tests of global cognition and executive function. Interventions offered to patients included combination antiretroviral therapy modification, signposting to other services, case management, further health investigations and in-clinic advice. Our experience suggests that the need exists for specialist HIV memory services and that such a model of working can be successfully implemented into HIV patient care. Further work is needed on referral criteria and pathways. Diagnostic processes and treatment offered needs to consider and address the multifactorial aetiology of CI in HIV and this is essential for effective assessment and management. MDPI 2019-02-08 /pmc/articles/PMC6406482/ /pubmed/30744034 http://dx.doi.org/10.3390/brainsci9020037 Text en © 2019 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Alford, Kate
Banerjee, Sube
Nixon, Eileen
O’Brien, Clara
Pounds, Olivia
Butler, Andrew
Elphick, Claire
Henshaw, Phillip
Anderson, Stuart
Vera, Jaime H.
Assessment and Management of HIV-Associated Cognitive Impairment: Experience from a Multidisciplinary Memory Service for People Living with HIV
title Assessment and Management of HIV-Associated Cognitive Impairment: Experience from a Multidisciplinary Memory Service for People Living with HIV
title_full Assessment and Management of HIV-Associated Cognitive Impairment: Experience from a Multidisciplinary Memory Service for People Living with HIV
title_fullStr Assessment and Management of HIV-Associated Cognitive Impairment: Experience from a Multidisciplinary Memory Service for People Living with HIV
title_full_unstemmed Assessment and Management of HIV-Associated Cognitive Impairment: Experience from a Multidisciplinary Memory Service for People Living with HIV
title_short Assessment and Management of HIV-Associated Cognitive Impairment: Experience from a Multidisciplinary Memory Service for People Living with HIV
title_sort assessment and management of hiv-associated cognitive impairment: experience from a multidisciplinary memory service for people living with hiv
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6406482/
https://www.ncbi.nlm.nih.gov/pubmed/30744034
http://dx.doi.org/10.3390/brainsci9020037
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