Current Status And Influencing Factors Of Mild Cognitive Impairment In Elderly Patients With HIV/AIDS

ObjectTo investigate the status quo of mild cognitive impairment(MCI)in elderly HIV/AIDS patients and analyze its influencing factors,to understand the real experience of elderly HIV/AIDS patients with MCI and the care status quo of main caregivers,and to provide a theoretical basis for the development of effective cognitive intervention programs and the construction of management models.Methods1.Quantitative research: From January to June 2022,553 elderly patients with HIV/AIDS were selected from a Yunnan infectious disease hospital and a public health center in Shanghai by convenience sampling method to conduct a questionnaire survey.A cross-sectional survey was conducted using the basic situation questionnaire,Montreal cognitive assessment,daily activity ability,fissile phenotype,hospital anxiety and depression,and Jenkins sleep scale.Montreal Cognitive Assessment Scale < 26 points,while professional doctors combined with patient history,physical examination and diagnostic criteria for MCI diagnosis,Univariate analysis,independent sample parameter test,independent sample non-parameter test,Spearman correlation analysis and multiple Logistic regression model were used to analyze the influencing factors of MCI in elderly HIV/AIDS patients.2.Qualitative research: 25 elderly HIV/AIDS patients with MCI and 25 of their main caregivers were recruited by objective sampling method in an infectious disease hospital in Yunnan from January to June 2022 for semi-structured in-depth interviews,and the collected data were analyzed by Colaizzi analysis method in phenomenological research.Results1.The incidence of MCI in elderly patients with HIV/AIDS was 43.8%.2.The scores of visual-spatial executive ability,naming,attention,language,abstraction,memory and orientation in the MCI group were lower than those in the NonMCI group(all P<0.05).Among all cognitive abilities,memory was the most severely impaired in the MCI group,followed by abstraction and visual-spatial executive ability.3.Univariate analysis showed that: Age,education,place of residence,BMI,number of children,type of work,monthly income,social frequency,family history of dementia,hypertension,diabetes,coronary heart disease,number of comorbidity,peak viral load,use of Efavirenz,albumin,globulin,fatigue,slow walking pace,decreased activity,decreased grip strength,stage of fattening,anxiety,depression,and sleep disorders were aged Influencing factors of MCI in HIV/AIDS patients.Multivariate analysis showed that:age(OR=2.206;95%CI: 1.344～3.60),education level(OR=0.116;95%CI: 0.030～0.449),residence(OR=4.714;95%CI: 1.566～14.192),the number of complications(OR=2.969;95%CI: 1.356～6.499),peak viral load(OR=1.060;95%CI: 1.009～1.112),asthenia(OR=3.095;95%CI: 1.365～7.017),depression(OR=1.788;95%CI: 1.261～2.534)was significantly correlated with MCI in elderly HIV/AIDS patients.4.The experience of elderly HIV/AIDS patients with MCI can be summarized into six main themes: disease perception of MCI,life experience,coping strategies,disease burden(economic pressure,physical and mental pressure),stigma,desire for medical treatment and family help;The main caregiver experience can be summarized into six main themes: lack of awareness of the disease,fear of the disease and worry about the prognosis,high stress(economic stress,physical and mental stress),stigma,positive coping with difficulties,and expectation of help(learning about the disease,professional support from medical staff,and support from family members).Conclusion1.The incidence of MCI in elderly HIV/AIDS patients is high,and high education level is the protective factor.Older age,living in rural areas,a large number of complications,depression,high peak viral load,and weakness are the risk factors for MCI in elderly HIV/AIDS patients.We should strengthen MCI screening for elderly HIV/AIDS patients and take effective measures to prevent and delay the occurrence and development of MCI as soon as possible.2.It is necessary to strengthen the popularization of disease knowledge for elderly MCI patients with HIV/AIDS and their main caregivers,pay attention to patients’ life experience and caregivers’ care experience,provide effective self and family nursing skills,attach importance to the physical and mental conditions and emotional needs of patients and caregivers,provide psychological counseling,improve the medical security system,and increase policy support,medical and social support.Personalized cognitive intervention was carried out to improve the cognitive status,improve the quality of life and promote healthy aging.