There are a number of reasons why people with HIV can experience cognitive impairment:
- the virus can cause HIV associated neurocognitive disorder (HAND), of which HIV associated dementia (HAD) is the most severe form
- infections such as toxoplasmosis or progressive multifocal leukoencephalopathy (PML) can occur when the immune system is weakened
- other illnesses unrelated to HIV can cause cognitive impairment (e.g. Alzheimer’s disease, stroke, alcohol and other drugs, etc.).
The Adahps psychologist can assist in the assessment and management of HIV associated cognitive impairment.
Why have a neuropsychological assessment?
A neuropsychological assessment can assist people with HIV who have concerns about memory loss, confusion and changes in their behaviours by:
- detecting cognitive impairment prior to it being detected by imaging techniques such as a CT or MRI scan
- determining the presence and degree of cognitive impairment
- checking whether medication has reduced some of the symptoms of HIV associated dementia
- identifying what is likely to be causing symptoms
- providing valuable insight into how to manage any areas of cognitive impairment and minimise their impact on the lives of the HIV positive person and their family and carers.
It is important to mention that a diagnosis will not be made on the basis of the outcomes of this assessment alone. Neuropsychological assessments are only one aspect of the overall assessment and management of cognitive impairment. The results are not 100% definitive and can be affected by a variety of factors including: motivation level, ill-health, extreme anxiety, low mood, fatigue or effects from medicines.
How to request an assessment
Most health professionals such as a GP, HIV specialist, nurse, social worker or case manager can make a referral. We also accept referrals from individuals or their family and carers. Adahps must be given permission to share the results with the individual's treating doctor or health team.
Our psychologist will travel anywhere in NSW to perform the assessment. The location will usually be in a sexual health or other health clinic, or occasionally at a GP practice.
A neuropsychological assessment usually involves three stages:
- Stage 1: The psychologist asks questions to obtain medical, social, psychiatric and any relevant family history.
- Stage 2: The individual completes a variety of tests to assess a wide range of cognitive functions including: memory, attention, language and executive functioning (i.e. the ability to plan, organise, solve problems and show flexibility of thought).
- Stage 3: The psychologist discusses the results and recommendations with the individual. These results and recommendations are also shared with the referrer via a written report. With the individual's permission it can also be sent to other health workers providing care.
Who is eligible?
To be eligible an individual will:
- live in or receive health care in NSW
- have suspected cognitive impairment that may be related to HIV.
Residents of SESLHD should be referred to the St Vincent’s Hospital neuropsychologist in the first instance.