HIV and Dementia
What is HIV-linked dementia?
HIV/AIDS affects many of the body's organ systems, including the brain and nervous
system. Most people don't know that HIV actually makes its way to the brain early
in the disease process. HIV encephalopathy is caused by HIV spreading in the brain
and harming it. It is one cause of dementia in people who have HIV. The greater the
spread of infection in the brain and the more damage that results, the worse the dementia
AIDS dementia is also called AIDS dementia complex or HIV-related dementia. It is
a serious result of HIV infection. It is most often seen in advanced stages of the
What causes HIV-linked dementia?
When HIV spreads to the brain, it causes inflammation and damage to brain cells. Unchecked
over time, it will often cause nervous system problems or thinking problems that lead
to dementia. The greater the spread of infection in the brain and the greater the
damage that results, the worse the dementia symptoms become. People with HIV may also
become infected with other organisms, such as cytomegalovirus and toxoplasmosis. They
can also develop cancer, such as lymphoma of the central nervous system. Each of these
infections or health problems can cause a drop in mental function, very much like
that caused by HIV.
What are the symptoms of HIV-linked dementia?
These are symptoms seen with HIV-related dementia:
Trouble concentrating or staying focused
Trouble speaking clearly or accurately
Lack of interest in activities you used to enjoy
Slow loss of motor skills, or less coordination
Rapid changes in mood
These symptoms may look like other health problems. Always see your healthcare provider
for a diagnosis.
How is HIV-linked dementia diagnosed?
Your healthcare provider will ask about your past health. You will also have a full
nervous system and sensory exam. You may also need these tests:
Mental status test. This is a brief and simple test of memory and some other common thinking skills.
It is often part of a full nervous system exam.
Basic tests of physical abilities or movement
MRI. This imaging test uses a combination of large magnets, radio waves, and a computer
to make detailed images of organs and structures in the body.
CT scan. This imaging test uses a combination of X-rays and computer technology to make images of
any part of the body, such as the bones, muscles, fat, and organs. CT scans are more
detailed than X-rays.
Spinal fluid test. During this procedure, a healthcare provider puts a hollow needle into the lower
back (lumbar spine).
How is HIV-linked dementia treated?
Treatment will depend on your symptoms, age, and general health. It will also depend
on how severe the condition is.
Treatment often involves:
Antiretroviral therapy. This treatment helps to control the HIV in the body and allows the body to try to
reverse some of the damage. It can sometimes help ease dementia symptoms. The best
way to prevent dementia is to take antiretroviral medicines from the time you are
diagnosed with HIV/AIDS diagnosis until you have an "undetectable" HIV viral load.
Substance or alcohol abuse counseling. People with HIV who abuse drugs or alcohol can have more severe dementia symptoms.
Prescription medicines. Along with other medicines you take for AIDS symptoms, your healthcare provider may
give you antidepressants, antipsychotics, or stimulants. Deciding on which one will
depend on what may be causing your dementia.
Lifestyle changes. A structured routine will help you to deal with some of the symptoms of dementia.
Writing lists can help you stay organized and remember important details. A neurologist
may advise working with a special therapist who can help you learn to better manage daily
Coping strategies. If dementia symptoms become severe, you may need help at home from a skilled caregiver.
People with HIV-related dementia may develop depression. They may need counseling
and possibly antidepressants or other treatments.
What are possible complications of HIV-linked dementia?
The slow loss of mental clarity and physical coordination can seriously reduce quality
of life and day-to-day function. People with the brain damage leading to dementia
can develop seizures (convulsions). Without treatment, HIV-linked dementia can be
What can I do to prevent HIV-linked dementia?
People who are taking antiretroviral therapy and have it well controlled ("undetectable
viral load") are much less likely to get HIV-related dementia. A milder form of thinking
problems (cognitive impairment) may still occur but is also less common than if the
person was not taking antiretroviral medicines. This condition is called HIV-associated
neurocognitive disorder (HAND).
Living with HIV-linked dementia?
Based on your level of dementia, you may need different therapies. HIV-linked dementia
may gradually get worse, especially if your HIV infection is not well controlled.
You will need more care as the disease gets worse over time.
When should I call my healthcare provider?
If you, a family member, or friend notice changes in your ability to speak, focus,
or concentrate, talk with your healthcare provider. These symptoms are common to other
health problems, such as other infections, depression, and nutritional deficiencies.
Also talk with your healthcare provider about unusual shifts in mood or emotions and
changes in social behavior. Best results are achieved with early diagnosis and treatment.
Key points about HIV-linked dementia
HIV-related dementia occurs when HIV spreads to the brain and continues to cause damage
without being controlled with antiretroviral medicines.
Symptoms of this type of dementia include memory loss, trouble thinking, trouble concentrating
or speaking clearly, lack of interest in activities, and slow loss of motor skills.
Medicines for treating HIV-related dementia include antiretrovirals, antidepressants,
antipsychotics, or stimulants.
People with HIV who abuse drugs or alcohol can have more severe dementia symptoms.
Your healthcare provider may suggest lifestyle changes and coping strategies that
can help you manage dementia.
Tips to help you get the most from a visit to your healthcare provider:
Know the reason for your visit and what you want to happen.
Before your visit, write down questions you want answered.
Bring someone with you to help you ask questions and remember what your provider tells
At the visit, write down the name of a new diagnosis and any new medicines, treatments,
or tests. Also write down any new instructions your provider gives you.
Know why a new medicine or treatment is prescribed and how it will help you. Also
know what the side effects are.
Ask if your condition can be treated in other ways.
Know why a test or procedure is recommended and what the results could mean.
Know what to expect if you do not take the medicine or have the test or procedure.
If you have a follow-up appointment, write down the date, time, and purpose for that
Know how you can contact your provider if you have questions.