In addition to HAND, PLHIV may be at risk of developing other forms of dementia.  Dementia is a term used to describe a group of conditions characterised by gradual impairment of brain function, which may impact cognition, memory, mobility, speech, personality, and behaviour. The most common form of dementia is Alzheimer’s disease; it is also common for an individual to have multiple types of dementia, known as ‘mixed dementia’. 

Examples of dementia include: 

• Alzheimer’s disease, the most common dementia diagnosis among older adults. It is caused by changes in the brain, including abnormal build-ups of proteins (amyloid plaques and tau tangles). 
• Vascular dementia is caused by conditions that damage blood vessels in the brain or interrupt the flow of blood and oxygen to the brain. 
• Lewy body dementia is caused by abnormal deposits of the protein alpha-synuclein, called Lewy bodies. 
• Alcohol-related dementia, from drinking excessive alcohol (Korsakoff’s syndrome and Wernicke-Korsakoff syndrome are forms of alcohol-related brain injury which may be related to alcohol-related dementia. 
• Frontotemporal dementia, a rare form of dementia that tends to occur in people under 60 years. It is associated with abnormal amounts or forms of the protein’s tau and TDP-43. 
• Mixed dementia, a combination of two or more types of dementia, often seen only on autopsy. 

Source: Dementia Australia (14). 

First Nations Populations 

First Nations people experience dementia at a rate 3 to 5 times higher than the general population and are more likely to develop dementia at a younger age (15). 

Many First Nations people view dementia as a natural part of the life cycle rather than an illness, as long as the person with dementia, their family and community, are safe. That is, if it doesn’t affect the connection to family, community, and culture. First Nations people require integrated services to be culturally safe and community-controlled so families and communities can care for people with dementia on Country. Use of culturally appropriate and co-designed screening tools for dementia and quality of life and creating culturally safe care plans such as the Kimberley Indigenous cognitive assessment (KICA) tool (15). 

More information is available at Dementia Australia and the Australian Institute of Health and Welfare.