HIV and Aging

 

Mental health

People with HIV have a higher rate of mental health disorders than the general population.

Stigma, isolation, trauma and the loss of friends and family can all contribute to this. Depression is the most common mental health condition and is seen in people with HIV of all ages. In some people, early symptoms of depression may include unexpected tiredness or lack of energy, problems falling asleep or staying asleep, or waking up and not feeling refreshed.

Possible physical causes of depression include:

  • anemia
  • low testosterone
  • low level of vitamin B12
  • low thyroid levels (especially in women)
  • hormonal changes for women that can be related to pre-menstrual syndrome (PMS), pregnancy, giving birth or menopause

HIV itself can also contribute to depression, and some treatments can cause these side effects: efavirenz (Sustiva, also in Atripla) can cause mental health problems, and a small proportion of people (one to three percent) who take integrase inhibitors such as raltegravir (Isentress), elvitegravir (in Genvoya and Stribild), dolutegravir (Tivicay, also in Juluca, Dovato and Triumeq) and bictegravir (in Biktarvy) experience anxiety, sleeping problems and depression. Symptoms of anxiety include a rapid heart rate, insomnia and extreme worry, and it is relatively common among people with HIV. If you are experiencing any of the above symptoms, it’s very important to see your doctor and get treatment and support.

Dementia is a brain disorder that can affect your memory and ability to think clearly. It can have a serious impact on your daily activities, your quality of life and even your ability to live independently. Fortunately, the HIV-associated dementia that was seen in the early days of the epidemic greatly declined after effective HIV treatments became available in the mid-1990s. Nevertheless, as you age, you may be at increased risk of developing what is now called HIV Associated Neurocognitive Disorder (HAND). This is a spectrum of cognitive, motor and/or mood problems that affects up to 50 percent of older people with HIV in Canada (estimates vary). Symptoms include difficulty remembering, concentrating, performing calculations or completing basic tasks, but most people with HAND have very mild impairment. It’s important to speak to your doctor as soon as possible if you become aware of these symptoms.