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Acquired immune deficiency syndrome (AIDS) dementia complex is a neurological disorder caused by infection with the human immunodeficiency virus (HIV). Most AIDS-related illnesses are the result of opportunistic infections, but AIDS dementia complex is caused by the HIV virus itself, sometimes in concert with opportunistic infections. Receiving early treatment for HIV infection can reduce the risk of developing dementia, and controlling AIDS can also limit the chances of neurological problems.
HIV is involved in the development of dementia in two different ways. The virus is capable of crossing the blood-brain barrier and can directly damage brain cells, leading to dementia. In addition, as the immune system declines in response to the viral infection, nerves are damaged, also contributing to the appearance of AIDS dementia complex. Sometimes, dementia is hastened by the development of AIDS-associated brain tumors and conditions caused by opportunistic infections.
Patients with AIDS dementia complex can experience a broad spectrum of symptoms, from symptoms so mild people don't even recognize them as dementia to a persistent vegetative state. People typically experience cognitive impairments worsening in severity over time, including difficulty speaking, memory loss, confusion, and agitation. In addition, motor skills decline and changes in behavior can also be observed. In patients who develop dementia not related to HIV infection, the dementia is often worse because of the presence of HIV.
The risk of developing AIDS dementia complex increases if the immune system is allowed to reach a critical state. Taking medications can keep blood cell counts high, limiting physical damage caused by a failing immune system. While AIDS dementia complex was once very common in AIDS patients, the advent of more advanced treatment regimens has decreased the incidence, with less patients developing dementia because their conditions are not allowed to become severe.
If the signs of AIDS dementia complex are identified, the patient should be evaluated by a neurologist. Medical imaging studies can be conducted to look for physical changes to the brain and the patient's condition can be assessed. Treatments can include changing drug regimens, physical therapy to help with motor skills, and supportive care to keep confused, agitated, or upset patients as comfortable as possible.
Dementia can be frightening, and patients may experience periods of lucidity or be very aware of the world around them without being able to communicate. It is important to be aware of this when interacting with patients who have dementia. Providing explanations for what is happening, speaking in a low, soothing tone, and treating patients with respect can greatly reduce agitation and distress.
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