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Noeline Nakasujja Chair, Department of Psychiatry College of Health Sciences Makerere University
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INTRODUCTION The prevalence of human immunodeficiency virus (HIV) in the over 60-age group is increasing, with increased access to HAART 1. Executive function and working memory constructs support higher cognitive function and are commonly affected by age 2 and HIV infection thus compromising cognitive function. 3
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BACKGROUND Sub-Saharan Africa (SSA) has almost 60% of the world’s HIV disease burden Close to 70% of those eligible for ART now receiving it In general; there is limited data regarding the experience of older HIV infected in low income countries/ sub-Saharan Africa.
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OBJECTIVE To compare the neuropsychological test performance among elderly HIV sero-positive individuals to HIV sero-negative counterparts.
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Color trail 2
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Digit Span
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METHODS Study Sites -The Adult Infectious Diseases Clinic (AIDC) in the Infectious Diseases Institute (IDI), at the College of Health Sciences, Makerere University Kampala, Uganda. - Assessment Center,Mulago Hospital
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Enrolment We recruited 121 HIV-positive individuals and 126 HIV negative individuals above 60 years. Neuropsychological performance was conducted using the Digit Span backward (for working memory) and Colour Trails 2 (for executive function). Test scores were compared using t-test
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Demographic data DomainHIV +ve group n=121HIV –ve group n=126P value Gender, male n (%)73 (60.33)48 (38.10)0.000 Age, Mean (SD)65.41322 (4.645194)68.14286 (6.682172)0.002 Residence, Own n (%)78 (64.46)70 (55.56)0.242 Education, Primary n (%)61 (50.41)68 (53.97)0.096 Marital status, married n (%)31 (25.62)52 (41.27)0.000 Medication prior to interview n (%) 119 (98.35)20 (16.0)0.000 Suffered mental illness, n (%)9 (7.44)5 (4.0)0.10
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Digit span
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Colour trail 2
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DISCUSSION No difference between HIV + and HIV-ve on working memory. HIV+ve had poorer executive function in comparison to the HIV-ve. Executive functioning is worse for the HIV– ve group however, possibly due to factors such as gender, level of education and type of physical activity.
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CONCLUSION Executive function and working memory assessments can be used to identify elderly populations at risk of non-adherence and compliance with medical instructions. More studies need to be done to generate normative data for the elderly population to quantify level of function in executive function and working memory
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References 1. Uganda Ministry of Health and ICF International. (2012). Uganda AIDS Indicator Survey 2011: Key Findings. Calverton, Maryland, USA: MOH and ICF International 2. Kearney, F., Moore, A. R., Donegan, C. F. & Lambert, J. (2010). The ageing of HIV: implications for geriatric medicine. Age and Ageing; 39: 536–541.
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