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Mini mental state examination and evaluation of factors associated with cognitive decline in HIV/AIDS-infected people = Miniexame do estado mental e avalia o de fatores que se associam à presen a de declínio cognitivo em pessoas vivendo com HIV/AIDS

Keywords: HIV/AIDS , MMSE , cognition , neuropsychological tests , HIV/AIDS , MEEM , cogni o , testes neuropsicológicos

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Abstract:

Neuropsychiatric complications are present in almost one third of patients diagnosed with AIDS who show wide variations in their clinical symptoms, featuring a spectrum of disorders ranging from minor cognitive-motor impairments to profound dementia. The Mini Mental State Examination (MMSE) is one of the most used and studied cognitive tests around the world and evaluates cognitive function and screening of dementia. Current experiment applies the MMSE to HIV/AIDS patients to screen possible dementia factors in the sample and to evaluate the association of scores that are positively associated with the emergence of cognitive impairment and possible dementia. The study population consisted of 100 HIV/AIDS patients attended at the 15 th and 17th Regional Health Centers covering 50 municipalities in the northwestern region of the state of Paraná, Brazil. Whereas patients were classified with cognitive impairment and patients without cognitive impairment, the factors assessed included depression, body mass index, haematocrit, hemoglobin levels, rate of lymphocytes T CD4+, viral load and gender. Twenty-seven (27%) patients had scores lower than expected and were considered cognitively impaired. There was a significant positive association between cognitive impairment and changes in blood hemoglobin and haematocrit, age and depression. Complica es neuropsiquiátricas est o presentes em quase um ter o dos pacientes com diagnóstico de AIDS e apresentam grande varia o na sua evolu o clínica, exibindo um espectro de sintomas que vai de disfun es cognitivo-motoras leves a demência profunda. O Miniexame do Estado Mental (MEEM) é um dos testes mais empregados e mais estudados em todo o mundo, e permite a avalia o da fun o cognitiva e o rastreamento de quadros demenciais. O objetivo deste trabalho foi aplicar o MEEM em pacientes portadores de HIV/AIDS de modo a rastrear possíveis quadros demenciais na amostra, bem como avaliar a associa o desses escores com os fatores carga viral plasmática maior que 50000 cópias mL-1, concentra o de hemoglobina menos de 15 mg dl-1, níveis de linfócitos CD4 inferiores a 200 células mL-1, baixo índice de massa corpórea, baixo hematócrito, idade avan ada, sexo feminino e depress o. A popula o estudada constituiu-se de 100 pacientes com HIV/AIDS atendidos na 15 e na 17a Regional de Saúde, abrangendo 50 municípios da Regi o Noroeste do Paraná, classificados em pacientes com comprometimento cognitivo e pacientes sem comprometimento cognitivo mediante a aplica o do MEEM. Foram avaliados os fatores depress o, índice de massa corpor

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