As they get older, patients with HIV can experience fuzzy thinking. They’re slower to process information, have trouble focusing and are often forgetful. Now they may be fighting for computer time with their grandkids. Researchers at the University of Alabama at Birmingham (UAB) published the results of a study in the November 2012 Journal of the Association of Nurses in AIDS Care showing that computer games can help restore mental function in seniors with HIV.
HIV penetrates the blood-brain barrier, which normally prevents unwanted substances from harming the brain. It then enters brain cells, or neurons, where it produces toxic proteins. In addition, many HIV drugs used long-term can affect the brain. Although newer antiretroviral therapies have helped reduce the rate of drug-related cognitive impairment, they can affect brain structure and function. (See “Tackling HIV,” HemAware, Winter 2013, p. 20.)
The researchers estimate 30% to 60% of adults with HIV develop HIV-associated neurocognitive disorders. According to the US Centers for Disease Control and Prevention, 25% of patients with HIV are 50 and older; the number could double by 2015. So the need for brain training will grow as HIV patients grow older.
Symptoms of neurocognitive impairment (NCI) include confusion, short- and long-term memory loss, difficulty planning and solving problems, and motor skill and coordination dysfunction. NCI can prevent people from accomplishing so-called “activities of daily living” (ADL), such as managing prescriptions, balancing a checkbook, driving and working.
“It’s imperative for people with HIV and their treatment teams to be proactive in addressing cognitive problems as they emerge,” said David E. Vance, PhD, lead author of the study, in an October 16, 2012, press release. He is an associate professor in the UAB School of Nursing. HIV-related cognitive issues can simulate premature aging, interfering with a person’s ability to work and live independently.
Of the 46 patients with HIV enlisted for the study, half underwent up to 10 hours of speed of processing training during a five-week period. The rest were in a control group. The computerized information processing program was chosen because of its proven track record in helping older people without HIV regain mental function.
Participants in the study played a series of computer games, including “Jewel Diver” and “Road Tour,” created by Posit Science of San Francisco. The tests were self-administered using a touch-screen monitor on a computer. When subjects correctly identified what they saw or where they saw it, they were rewarded with points. After each correct answer, the questions sped up progressively.
The study group showed improvement on two tests. One measured visual speed of processing, often used to improve driving skills. The other measured the accuracy and length of time it took to perform a handful of ADL tasks, such as making correct change using coins. In a post-test survey, more than 90% said the computer games improved their mental ability, memory, speed of processing information and attention.
Although the study was small, it supported previous data showing computer training can improve information and visual processing in older people. In the future, computer games may be one way for patients with HIV to stay mentally sharp as they age.