neuropsych of HIV Flashcards
HIV associated neurocognitive disorders
HAD=HIV associated dementia
MND=mild neurocongnitive disorder
ANI=asymptomatic neurocognitive impairment
HAD
marked aquired impairment in cognitive functioning involving at least 2 ability domains.typically impairment is in multiple domains especially in learning of new information,slowed information processing and defective attention
2 SD or greater than demographically corrected means
impairment affect daily living
HAD is a subcortical dementia
see memory deficit and psychomotor slowing
takes months to develop
RF for HAD
low CD4
high viral load
anemia
low BMI
increasing age
IVDA
female
prevalence of HAD
is reducing with HAART
MND
acquired impairment in cognitive functioning involving at least two ability domains documented by performance of at least 1.0 SD below the mean for age-education-appropriate norms on standard neuropsych tests
mild interference in daily activity:
1) self-report of reduced mental acuity OR
2) observation by knowledgeable others that individual has undrgone at least mild decline in mental acuity
MND is a subtle form of HAD
Formerly known as…
AIDS dementia complex
mild impairment in social and occupational functioning
rule out encephalopathy, infx and tumors first
ANI
acquired impairment in cognitive functioning involving at least 2 ability domains documented by performance of at least 1.0 SD below mean for age-education-appropriate norms on standardized neuropsych tests
does not intefere with daily functioning
does not meet criteria for dementia or delirium
no evidence for another preexisting cause for ANI
Review
screening test for
attention and concentration
language/speech and speed of congnition
executive/psychomotor
Tx
memantine
selegiline
stimulants
