AIDS is often considered a disease of the young, but using projections based on the incidence of cases as of December 1989, researchers estimate that by 1992 there will be 10,000 AIDS patients over the age of 60.
Older patients with AIDS are sicker and have a more rapid decline in health. Treatment using azidothymidine (AZT), currently the most extensively used drug against HIV-1 , may not be effective because older patients have more frequent adverse reactions to medications.
A significant cause of morbidity with an HIV-1 infection is AIDS dementia complex. Approximately two thirds of all AIDS patients will develop clinical evidence of this syndrome, initially manifested by subtle changes in a patient's attention span, concentration, and personality and often accompanied by motor dysfunction. In some older patients, the onset of this syndrome may appear before the diagnosis of AIDS has been made and may be mistaken for Alzheimer's disease or Parkinsonism. In its most severe form, the disease progresses to an end-stage dementia characterized by diffuse weakness, mutism, and bowel and bladder incontinence.
Most AIDS patients eventually will not be able to care for themselves. Older AIDS patients more often require functional assistance sooner and may be without family support systems. Even when children or other family members are willing to provide home care, the medical needs of these patients can be overwhelming.
How can these patients be cared for? A recent trend has been to recruit healthy older people to assist in home health care. Local and state agencies are compensating caretakers for bringing adult and infant AIDS patients into their homes.
Eventually, whether as volunteer caretakers, health professionals, coworkers, relatives, friends, or nursing home residents, most older Americans will know someone with AIDS; thus, expanded AIDS education geared toward the elderly population is needed. Increasingly, the community must become involved in providing home care for dying AIDS patients. Such efforts will help improve the quality of life of the many older Americans yet to develop AIDS.
For more information, contact Linda Krogh Harootyan or Shirley V. Brown, The Gerontological Society of America, 1275 K Street, NW, Suite 350, Washington, DC 20005-4006; 202-842-1 275.