Increased Dementia Risk Among Adults Living with HIV in Malawi
A study reveals that adults with HIV in Malawi are twice as likely to suffer from dementia compared to those without HIV. The findings highlight the burden of dementia among people living with HIV and signify the necessity for focused research and healthcare improvements in resource-poor regions. The study indicates a strong correlation between HIV, aging, and increased dementia risk in Malawi, urging the development of culturally relevant management strategies.
A recent study conducted by researchers from the United States and Malawi indicates that adults living with HIV in Malawi are more than twice as likely to develop dementia compared to those without HIV. The findings, published in the journal Alzheimer’s and Dementia, underscore the significant burden of dementia among individuals with HIV in Malawi and emphasize the necessity of studying dementia in resource-limited environments.
Advancements in antiretroviral therapy have enabled individuals with HIV to lead longer lives; however, aging with HIV poses additional health challenges. The virus heightens the risk of developing various age-related illnesses such as diabetes, heart disease, cancer, and notably, dementia, due to associated inflammation and brain changes.
In Malawi, a country where 8 to 12 percent of adults are diagnosed with HIV, life expectancy has improved considerably. For instance, children born in 2000 are expected to live until 45 years of age, while those born in 2021 are predicted to live until approximately 63 years. With the aging population in sub-Saharan Africa, experts warn of an anticipated increase in dementia cases in the future.
Haeok Lee, a professor at NYU Rory Meyers College of Nursing and the study’s lead author, remarked, “Most of what we know about dementia and Alzheimer’s disease comes from research studies in high-income countries, but less is known about dementia prevalence and risk in low- and middle-income countries.”
To investigate the prevalence of dementia in individuals with and without HIV, the researchers analyzed medical records from 400 adult patients aged 30 and older who attended an outpatient clinic in Lilongwe, Malawi. Of the participants, half were HIV-positive and receiving antiretroviral therapy, while the other half did not have HIV. Results showed that 22 percent of those with HIV had dementia, in contrast to 10 percent of those without HIV.
The study found that while dementia prevalence increased with advancing age in both groups, individuals with HIV experienced a more pronounced increase and were diagnosed at younger ages. Notably, depression and unstable employment were identified as significant risk factors for dementia among individuals with and without HIV.
The researchers acknowledged limitations in their methodology, including challenges in analyzing paper medical records, the absence of standardized diagnostic codes, and a lack of data on substance use. Furthermore, the scarcity of healthcare professionals in Malawi—illustrated by the presence of only one neurologist for the entire adult population—suggests that dementia may be underdiagnosed due to inadequate screening practices.
Jonathan Ngoma, study author and representative of Kamuzu Central Hospital and the Malawi Ministry of Health, emphasized the need for improved dementia care in low- and middle-income countries. He stated, “We need to do more in order for us to look after patients with dementia in low- and middle-income countries. We have embarked on a journey to bring out a lot of information to the world.”
Lee further noted the urgent requirement for developing appropriate infrastructures for dementia management in Malawi, including culturally adapted cognitive assessment tools and treatment guidelines tailored to local needs. The study is set to be published in a special issue of Alzheimer’s and Dementia dedicated to dementia research in Africa, with contributions from a diverse group of researchers.
In conclusion, the study reveals that adults with HIV in Malawi face a significantly higher risk of developing dementia compared to their counterparts without HIV. Given the rising life expectancy and aging population, it becomes imperative to address the challenges associated with dementia in this context. The findings advocate for the need for better healthcare infrastructures to manage dementia and to raise awareness regarding its prevalence, contributing to improved health outcomes in Malawi.
Original Source: www.nyu.edu
