Are Mental Issues to Blame For a Decline in Daily Functions?

Despite that one in five HIV-positive people blame cognitive issues like memory loss, poor concentration, and reduced attention span for a decline in everyday functioning, researchers are now concluding these problems might not be the root cause. 

In fact, researchers say it’s conditions such as depression, anxiety, or worries about being able to afford basic needs that tend to cause a decline in daily functions, and people living with HIV ought to assess for “these problems first before concluding that the underlying problem is a physical decline in cognitive function,” reports AIDS Map. 

Results from the study were reported in the Journal of Acquired Immune Deficiency Syndromes. While prior research shows that HIV-positive people have higher prevalence for cognitive impairment, for most cases it was so low that it had virtually no impact on daily functions. 

Studies have shown that 22 percent of people living with HIV will be diagnosed with major depression, while up to 64 percent might be dealing with Post Traumatic Stress Disorder. As a result of these kinds of mental issues, those living with such co-morbidities often don’t take their medication, which makes the depression even worse.

Researchers in the CIPHER study sought to figure out factors that caused a decline in most daily functions by giving standard tests (which involved 16 separate activities) to 448 participants between 2011 and 2013 — 89 percent were on antiretroviral therapy and 81 percent were undetectable. 

Overall, the most commonly reported daily difficulties had to do with social activities, work, housekeeping and reading or watching TV. The study showed an association of their decline to poorer speed/reaction time, attention span, and memory lapses, which of course are all measurements of cognitive impairments. However, other factors included, “difficulty affording basic needs, being unable to work or unemployed, depression, anxiety and being diagnosed with HIV for at least five years,” reports AIDS Map. 

“All our observed associations may have multiple explanations, and causality could be in either direction,” the authors wrote. “These results imply that patients who report symptoms of cognitive impairment, or declining everyday function, should be assessed for depression, anxiety, concomitant medical conditions and financial difficulties. Failure to recognize these important elements of patients’ lived experiences risks diagnostic delay, failure to address important needs, unnecessary investigations and further anxiety.”

Further studies are needed to decide whether improving one’s mood or anxiety can also improve cognitive tests. 

But given the fact that these causes are super complex, researchers concluded that doctors and physicians ought to be careful crediting cognitive issues to a decline in daily functions, but rather look at the symptoms of other causes — such as depression and anxiety — as a likely cause as well.