Aging with HIV: Research finds increased risk of dementia

People with HIV are living longer lives. That’s good news. However, it also means they’re more likely to live long enough to develop age-related diseases, such as dementia.

Dementia is a loss of mental skills that affects your daily life. It can cause problems with memory, problem-solving, and learning.

The risk of dementia among older adults with HIV is higher compared to people without the virus, according to recent Kaiser Permanente research.

The lead author of the study, Jennifer Lam, PhD, a research scientist for the Kaiser Permanente Division of Research, has received federal funding to learn more about this increased risk.

“It’s inspiring to see the advancements in HIV care that enable people to live longer lives,” Lam said. “Effective medications have transformed HIV into a manageable condition for most patients. That’s why it's important to address the health concerns that come with aging.”

Double the risk of dementia

More than half of people with HIV in the U.S. are over age 50. We already had evidence that they’re more likely to get cancer and heart disease. But we didn’t know much about the risk of age-associated dementia in older adults with HIV.

In the 2022 study led by Lam, she and her team compared about 13,000 Kaiser Permanente patients with HIV to more than 155,000 people without HIV. Everyone studied was age 50 or older. And the people in each group were similar by gender and race.

The researchers looked at 16 years of patient health data. They found that 2.5% of the people with HIV were diagnosed with dementia compared with 1.3% of the people without HIV.

On average, people with HIV were diagnosed with dementia 10 years earlier than other patients.

Expanding the research

To learn more about cognitive problems (such as memory loss) and dementia in older adults with HIV, our researchers have expanded the scope of their work.

They’re studying people in several areas across the U.S. where Kaiser Permanente provides care. They pooled patient health data on more than half a million older people, comparing more than 24,000 people with HIV with a larger, similar group of people who don’t have HIV.

“We’re studying more people to increase diversity and representation in our research,” Lam said. “We expect to study these patients for many years. We want to better understand patient well-being and care delivery in the growing population of older people with HIV.”

How to age well with HIV: Seeking answers

Next, our researchers plan to explore why dementia risk might be higher in people with HIV.

The virus itself can affect the brain, even among people on HIV medication. Our researchers are looking at factors such as:

• How quickly patients with HIV started medication
• Whether they take medication regularly
• Patients’ blood pressure levels
• The effects of other illnesses related to age

To guide their work, our researchers asked people with HIV and their doctors what they would want to know.

“They wanted to understand whether forgetfulness and other thinking problems were related to HIV or just a part of natural aging,” Lam said. “Patients also wanted to know how to age well and take good care of themselves.”

Anyone can take steps to keep their brain healthy, according to neurologist Craig Hou, MD, who is on the research team.

“We encourage everyone to eat a heart-healthy diet, stay physically active, and keep their minds active,” said Dr. Hou.