HIV Mental Health Research Unit, Department of Psychiatry and Mental Health, Neuroscience Institute.
Division of Geriatric Medicine, Department of Medicine, University of Cape Town, Cape Town, South Africa.
AIDS. 2019 Sep 1;33(11):1765-1771. doi: 10.1097/QAD.0000000000002257.
We explored the prevalence of HIV infection in older rural South Africans and its associations, as well as the point prevalence of dementia and its associations with HIV and aging.
We utilized a cross-sectional analytic design.
Using the brief Community Screening Instrument for Dementia together with a rapid HIV test, we conducted a home-based screening survey among 1150 older South Africans. We explored the prevalence of HIV and dementia, and their associations using descriptive statistics and logistic regression analysis.
The HIV prevalence was 4.78%. Overall, participants were on average 71.3 years old, with nearly 70% having no primary school education. HIV+ participants were significantly younger, more likely to be single and had lower BMI. The overall dementia prevalence was 11.04%. HIV+ participants had higher rates of dementia compared with HIV- participants (18.18 vs. 10.68%) but the difference was NS. In adjusted analysis, screened dementia was associated with older age, the presence of self-reported depression and HIV+ status. Participants were also more likely to self-report cognitive impairment if they were older, depressed and had objective evidence of dementia.
Infection with HIV in rural older South Africans is a prevalent problem, and together with older age, is a significant contributor to cognitive impairment. It is possible that HIV infection contributes to dementia on the basis of an acceleration of degeneration - because our HIV-infected participants were younger - AND an accentuation of aging - because of the higher rates of impairment for similar age groups.
我们探讨了南非农村老年人中 HIV 感染的流行情况及其相关性，以及痴呆的时点患病率及其与 HIV 和衰老的相关性。
我们采用了横断面分析设计。
使用简短的社区痴呆筛查工具和快速 HIV 检测，我们对 1150 名南非老年人进行了家庭筛查调查。我们使用描述性统计和逻辑回归分析探讨了 HIV 和痴呆的流行情况及其相关性。
HIV 的流行率为 4.78%。总体而言，参与者的平均年龄为 71.3 岁，近 70%的人没有接受过小学教育。HIV+参与者明显更年轻，更有可能单身，BMI 更低。总的痴呆患病率为 11.04%。与 HIV-参与者相比，HIV+参与者的痴呆发生率更高（18.18%比 10.68%），但差异无统计学意义。在调整分析中，筛查出的痴呆与年龄较大、存在自我报告的抑郁和 HIV+状态有关。如果参与者年龄较大、抑郁且有认知障碍的客观证据，他们也更有可能自我报告认知障碍。
在南非农村的老年人中，HIV 感染是一个普遍存在的问题，与年龄增长一起，是导致认知障碍的重要因素。HIV 感染可能通过加速退行性变（因为我们的 HIV 感染参与者更年轻）和强调衰老（因为类似年龄组的损伤率更高）来导致痴呆。
