Evaluation Of Mental Status Research Articles

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Introduction: Objective measures with precise guidelines are employed to ensure standardized and reproducible assessments of the mental status of patients in the medical intensive care unit (MICU). We hypothesize that, despite using similar clinical scoring tools, there is still discordance between nurse and physician evaluation of patients' mental status. Methods: An IRB-approved cross sectional trial evaluating the mental and sedation status of all patients in the MICU during the daytime was performed. Using our electronic medical record we recorded the last documented nursing (RN) assessment of each patient's mental and sedation status by the Glascow Coma Scale (GCS), Confusion Assessment Method for the ICU (CAM-ICU), and Richmond Agitation and Sedation Score (RASS). We then assessed the same evaluations by a study physician's (MD). We compared both evaluations. Results: One hundred and twenty seven patients were evaluated who were in the hospital for a mean ± SD of 11 ± 14 days. The mean age was 61 ± 16 years and 53 % were male. 44 % of patients were mechanically ventilated and 11 % were on vasopressors at the time of evaluation. Nine percent were on continuous sedation. Discrepancies between RN and MD scoring of the GCS occurred in 31% of patients; 32% of patients in RASS evaluation; and 24% of patients in CAM-ICU assessment. There was good overall correlation between RN and MD scoring with both GCS (r2 = 0.72, p< 0.001) and RASS (r2 = 0.74, p< 0.001). In patients who are awake (RAAS of 0), nurses and physicians had excellent agreement. However, in sedated patients (RAAS ≤ -1), the physicians score patients with a lower RASS than nurses. There was better agreement between MD and RN evaluations of GCS. Physicians were more likely to score a patient as CAM-ICU positive as compared to RN (58 vs. 8 patients, p<0.001). RN were more likely to document inability to complete the CAM-ICU (38 vs. 6 patients, p<0.001). Nurses documented inability to assess CAM-ICU across the spectrum of RASS scores, whereas physicians only documented inability to perform CAM-ICU in patients with a RASS -4 or -5. Conclusions: Significant heterogeneity exists in the results of standardized mental status assessments in the MICU. Objective evaluations suffer from inherent subjectivity of the evaluator and fluctuations in the mental status of critically ill patients. We hypothesize that the implications in management and patient outcomes may be very important.

Predictors of functional outcome in Saudi Arabian patients with stroke after inpatient rehabilitation

To identify the possible factors influencing functional outcome of stroke patients after inpatient rehabilitation. One hundred and eighty patients with stroke consecutively admitted for inpatient stroke rehabilitation was studied. Demographic and stroke characteristics, impairment (National Institutes of Health Stroke Scale), disability level (Functional Independence Measure [FIM]), psycho-emotional state (Geriatric Depression Scale-15 [GDS-15]), cognitive function (Mini Mental State Evaluation [MMSE]), and preexisting medical conditions were recorded at admission. The main measure of functional outcome was the discharge FIM score. The univariate and multiple linear regression analyses were performed. The Mean admission total FIM score was 64.8 ± 22.4 and the mean discharge total FIM score was 84.0 ± 23.0, with this gain being highly significant (P < 0.001). Univariate analyses indicated that the significant factors influencing functional outcome of stroke patients at discharge from rehabilitation included age, total FIM score at admission, severity of stroke, recurrent stroke, cognitive impairment, and depression. However, in multiple linear regression analyses, age was not significant predictor. Age predicts the function outcome to lesser extent than other covariate. The admission total FIM score, cognitive condition, depression, and stroke severity are predictors of functional outcome of stroke patients after inpatient rehabilitation.

Effect of comprehensive psychological intervention on health behavior and negative emotions in retired people

Objective To investigate the awareness rate of health knowledge, health behavior formation rate and psychological state before and after retirement intervention, analyse comprehensive psychological intervention and general psychological intervention to health behavior formation and improve the negative emotion in retired population. Methods By using cohort study method, 206 retired people were randomly divided into comprehensive psychological intervention group (experimental group) and only given general psychological intervention group (control group), and each group included 103 cases. Comprehensive psychological intervention group were given health behavior and cognitive intervention, psychological intervention, psychological intervention in general family and social family care intervention, and the control group was given healthy behavior and cognitive intervention, psychological intervention. The staff were treated within 1 weeks of first assessment, 2 weeks after the second assessment, 4 weeks after the final.Health behavior was surveyed by Ministry of finance, the Ministry of health on public health subsidies special funds notice in city community health education pilot project in the questionnaire. Health status and quality of life were assessed with the family APGAR index (APGAR). Mental state evaluation and assessment of the treatment effect by using Hamilton Depression Scale (HAMD), MBI index method was assessed with activities of daily living. The effect of the two groups were compared before and after the intervention of health knowledge rate and formation rate of different intervention methods and psychological state of health behavior. Results The results showed that there were no significant differences between experimental group and control group in age, sex, level of education and other social, and there was no significant difference in HAMD, MBI and APGAR scores at baseline. Through the implementation of the comprehensive of psychological intervention, subjects have varying degrees of improving the awareness rate of health knowledge, and the intervention group was significantly higher than the control group (P<0.05). The two group of healthy behavior of subjects in the chopping board monitoring, physical fitness, blood pressure to separate raw and cooked on such projects had different degrees of improvement, at the same time, although no intervention, in the monitoring of blood pressure. The control group increased compared with the baseline significantly (P<0.05). Intervention group had significant difference in APGAR score increased (P<0.05). HAMD score and MBI score decreased and the differences were statistically significant (P<0.01), while the control group had no significant difference before and after intervention. Conclusion Comprehensive psychological intervention can significantly improve the rate of formation from the awareness rate of health knowledge and health behavior of retirees, and improve the state of negative emotions from retiree. Key words: Comprehensive psychological intervention; Retired population; Health behavior; Negative emotion; Cohort study

21. Occipital sources of resting state alpha rhythms are related to local gray matter density in subjects with amnesic mild cognitive impairment and Alzheimer’s disease

Occipital sources of resting state alpha rhythms are abnormal in patients with amnesic mild cognitive impairment (MCI) and Alzheimer’s disease (AD). Here we hypnotized whether the activity of these sources is related to neurodegeneration in occipital lobe as measured by magnetic resonance imaging (MRI). Resting-state eyes-closed EEG rhythms were recorded in 30 healthy elderly (Nold), 37 MCI, and 40 AD subjects. Neurodegeneration of the occipital lobe was indexed by weighted averages of gray matter density (GMD). EEG rhythms of interest were alpha 1 (8–10.5 Hz) and alpha 2 (10.5–13 Hz). EEG cortical sources were estimated by LORETA. Results showed a positive correlation between GMD in the occipital lobe and the magnitude of occipital alpha sources in the MCI and AD subjects. Furthermore, there was a positive correlation between the magnitude of alpha sources and the cognitive status as revealed by Mini Mental State Evaluation score all subjects. These results suggest that in amnesic MCI and AD subjects, occipital sources of resting state alpha rhythms reflect AD neurodegeneration in the occipital lobe. Cortical sources of resting state EEG rhythms in AD patients are promising for preliminary screening of elderly subjects at risk for AD.

Methodological Issues Associated with Sign-Based Neuropsychological Assessment

Aspects of neuropsychological assessment are used in a wide range of clinical and research settings. Over the past half century, in conjunction with the recognition that American Sign Language (ASL) is indeed a language and not simply a communication system, research using signed administration of tasks has increased, and clinicians have attempted to adapt or develop instruments for use with deaf clients. However, simply signing instructions or test stimuli does not “translate” a test into ASL even when the instructions or items are interpreted into linguistically accurate ASL. A number of challenges and issues arise when attempting to either modify an English-based measure for use with ASL or develop measures directly in ASL. These challenges and issues are reviewed as they relate to the broad areas of language assessment, the evaluation of mental status, memory testing, and the assessment of executive functioning, and the reader is directed to further materials that address each area in greater depth.

Association between somatic amplification, anxiety, depression, stress and migraine.

BackgroundThe aim of this study is to investigate the associations between migraine related disability and somatosensory amplification, depression, anxiety, and stress.MethodFifty-five migraine patients who applied to the outpatient unit of the Neurology Department of Acibadem University School of Medicine, Maslak Hospital in Istanbul, Turkey, and twenty-eight subjects without migraine were recruited for the study. The participants were asked to complete a sociodemographic form, Migraine Disability Assessment Scale (MIDAS), Depression Anxiety Stress Scale, Somatosensory Amplification Scale (SSAS).ResultsSomatosensory amplification scores were significantly higher in the migraineurs than in the control group (29.85+/−6.63 vs 26.07+/−7.1; p=0.027). Somatosensory amplification scores and depression scores were significantly higher in migraineurs with moderate and severe disability than in patients with minimal and mild disability (31.7+/−6.4 vs 27.71+/−5.49; p=0.01, 11.27+/−8.7 vs 7.38+/−8.11; p=0.04, respectively). A significant positive correlation was found between the frequency of migraine attacks for at least three consecutive months (MIDAS A scores) and the SSAS scores (r=0.363, p=0.007) in migraineurs. The MIDAS total scores were also significantly correlated with the DASS depression subcale scores (r=0.267, p=0.04), and the DASS stress subscale scores (r=0.268, p=0.05).ConclusionPsychological factors, and vulnerability to bodily sensations may incease the burden of migraine. We point out that the timely assessing of somatic amplification and the evaluation of mental status would help improve the quality of life of in migraineurs.

Association between cognitive function and nutritional status in elderly: A cross-sectional study in three institutions of Beirut—Lebanon

Abstract Introduction The percentage of demented elderly is increasing worldwide and in Lebanon. Improvement in nutritional status would improve cognition in elderly. The purpose of this work is to investigate the presence of an association between nutritional status and cognitive function in elderly living in Lebanese institutions. Materials and methods This is a cross-sectional study performed in three long-stay elderly institutions in Beirut. Subjects who met the inclusion criteria filled out a questionnaire consisting of nutritional status scale (Mini Nutritional Assessment: MNA), cognitive function (Mini Mental State Evaluation: MMSE) and other parts (demographic, self-assessment of the state health, smoking and alcohol, physical dependence, quality of life, frailty, depression, social isolation and loneliness). Results Among 111 elderly (55 men and 56 women), 14(12.6%) elderly are malnourished, 54(48.7%) are at risk of malnutrition and 43(38.7%) had adequate nutrition. The majority of malnourished elderly (71.43%) showed a cognitive function deterioration (MMSE Conclusion Nutritional status is associated with cognitive function. Monitoring the status of elderly can help in preventing malnutrition and possibly their cognitive impairment.

Operationalizing the MDS 3.0 in the Nursing Home

Many thanks to Dr. Debra Saliba and others for their excellent work overviewing and testing the Minimum Data Set (MDS) 3.0 revisions (article series in the Journal, Issue 13, 2012). Revisions and further testing were long overdue. As noted in her articles, the validated interviews embedded into MDS 3.0 have improved the reliability, validity, and clinical utility of the MDS. With better mental status and depression symptom evaluation interviews, the Resident Assessment Instrument (RAI) process can better support processes for individualized care.

Cortical Sources of Resting State EEG Rhythms are Sensitive to the Progression of Early Stage Alzheimer's Disease

Cortical sources of resting state electroencephalographic (EEG) rhythms are abnormal in subjects with Alzheimer's disease (AD). Here we tested the hypothesis that these sources are also sensitive to the progression of early stage AD over the course of one year. The resting state eyes-closed EEG data were recorded in 88 mild AD patients at baseline (Mini Mental State Evaluation, MMSE I = 21.7 ± 0.2 standard error, SE) and at approximately one-year follow up (13.3 months ± 0.5 SE; MMSE II = 20 ± 0.4 SE). All patients received standard therapy with acetylcholinesterase inhibitors. EEG recordings were also performed in 35 normal elderly (Nold) subjects as controls. EEG rhythms of interest were delta (2-4 Hz), theta (4-8 Hz), alpha 1 (8-10.5 Hz), alpha 2 (10.5-13 Hz), beta 1 (13-20 Hz), beta 2 (20-30 Hz), and gamma (30-40 Hz). Cortical EEG sources were estimated by low-resolution brain electromagnetic tomography (LORETA). Compared to the Nold subjects, the mild AD patients were characterized by a power increase of widespread delta sources and by a power decrease of posterior alpha sources. In the mild AD patients, the follow-up EEG recordings showed increased power of widespread delta sources as well as decreased power of widespread alpha and posterior beta 1 sources. These results suggest that the resting state EEG sources were sensitive, at least at group level, to the cognitive decline occurring in the mild AD group over a one-year period, and might represent cost-effective and non-invasive markers with which to enrich cohorts of AD patients that decline faster for clinical studies.

Prevalence and issues of screening for alcohol consumption among elderly inpatients admitted to acute geriatric inpatient unit

alcohol use disorders in the elderly are often underdiagnosed in spite of their effects worsened by age-related physiological changes, comorbidities and frequent polymedication. the aim of this study was to assess the prevalence of alcohol use in a geriatric acute care unit. a prospective and descriptive study was carried out in an acute care geriatric unit in France, from November 2011 to March 2012. It included inpatients aged 75 and older. We gathered medical data from medical records and conducted one-to-one interviews assessing the inpatients' weekly alcohol intake and personal history of alcohol use. We screened alcohol abuse and dependence by using parts of the MINI (Mini international neuropsychiatric interview). We also assessed benzodiazepine and tobacco consumption. Comprehensive geriatric assessment was conducted using the CIRS-G (cumulative illness scale in geriatrics), the MMSE (Mini mental state evaluation), the MNA (Mini nutritional assessment), the mini GDS (mini Geriatric depression scale) and the 4-IADL (4-Instrumental activities of daily living). Patients were dispatched in five groups according the DSM-IV-TR classification. the study included consicutively 100 inpatients (53 women and 47 men), with a mean age of 84.8±5.4 years. Forty-four percent had alcohol use disorders (29% at-risk users, 11% harmful users and 4% dependent). Very few inpatients with alcohol use disorders had been asked in the past about their alcohol consumption. They used benzodiazepine more often than the others. We did not find any differences in geriatric assessment when comparing the two sub-groups. alcohol use disorders are very common in elderly inpatients of acute geriatric care units, especially when considering the group of at-risk users. Alcohol use should thus be screened for every elderly inpatient.

Emerging mental disorders in a community sample of young adults in Italy: help-seeking in a Generalist Community Mental Health setting

Delays in the admission to care of young adults with emerging mental disorders represent one of the current major concern in psychiatry. This delay, often experienced in clinical practice, has several determinants. One of these is "unexpressed help-seeking" that is influenced by cultural and historical backgrounds and by the characteristics of the disorder itself, but most of all by the way community mental health services are developed. The aims are to identify: level of stress and mental unease and main determinants of unexpressed help-seeking within a community sample of young adults in a national contest of generalist community mental health model. the sample is made up of 3,446 university students. An explorative questionnaire together with SVS (Stress related Valuation Scale) for the assessment of subjective stress and GHQ-12 for the evaluation of mental health status were given. A descriptive analysis was carried out followed by correlations between unexpressed help-seeking variable and other variables. A logistic regression was carried out on the subsample with GHQ-12 ≥4 utilizing "non help-seeking" as a dependent variable. 46.8% of the sample had a GHQ-12 ≥4 score. The amount of unexpressed help-seeking is equal to 63.6% and ends up being significantly correlated to: male sex, nonresident student, high SVS score, absence of Youth Mental Health Services, distrust manifested in relation to existing Services. A modification of the Community Mental Health Services in the sense of setting up more appropriate contexts for young users, could lead to a reduction of unexpressed help-seeking.

Medical students′ and residents′ conceptual structure of empathy: A qualitative study

Empathy is a crucial component of medicine. However, many studies that have used quantitative methods have revealed decline of learners' empathy during undergraduate and postgraduate medical education. We identified medical students' and residents' conceptual structures of empathy in medicine to examine possible differences between the groups in how they conceive empathy. We conducted a qualitative study with two focus group discussions in which six medical students and seven residents participated separately. The transcripts of the focus group discussions were analysed combining qualitative data analysis and theoretical coding. Medical students and residents had different conceptual structures of empathy. While medical students thought that sharing emotions with patients was essential to showing empathy, residents expressed empathy according to their evaluation of patients' physical and mental health status. If the residents thought that showing empathy was necessary for the care of patients, they could show it, regardless of whether they shared the patients' emotions or not. The comparison of medical students' and residents' conceptual structures of empathy reveals a qualitative difference. Residents show more empathy to their patients by a cognitive decision as clinicians than medical students do. Communication skills training should consider the qualitative change of students' and residents' empathy with clinical experience. We should consider the change when we evaluate learners' empathy and introduce methods that cover the qualitative range of empathy.

URINARY TRACT INFECTIONS Mental status in patients with chronic bacterial prostatitis

IntroductionChronic prostatitis is a widespread urological disease with a lengthy course and a propensity to frequent recurrences. Adequate response to anti–inflammatory therapy is lacking in a high percentage of patients, which causes them to seek medical advice from different doctors. Thus, the physicians are challenged to look for other reasons causing the pathological symptoms.Material and methodsWe have reviewed the patients with treatment–resistant chronic bacterial prostatitis (CBP) from the perspective of psychosomatic medicine. For the evaluation of primary mental status and treatment control we used standard approved questionnaires. All 337 CBP patients initially underwent therapy aimed at pathogen eradication. If psychopathological symptoms were evident and dominated over urological ones, the patients were referred to psychiatric evaluation and treatment.ResultsThe frequency of concomitant psychosomatic disorders (PSD) in patients with CBP was 28.2% and neurotic disorders – 26.4%. Adequate multimodal anti–inflammatory therapy followed by a few sessions of psychotherapy decreased the manifestations of PSD in 30.5%, neurotic disorders in 51.7%, and premature ejaculation in 60.5% of patients with CBP. The addition of pharmacotherapy to psychotherapy is effective in treatment–resistant cases. However, after multimodal treatment, 31.5% of pts. with PSD and 13.5% of pts. with neurotic disorders still remain treatment–resistant and required in–depth long–term psychiatric care.ConclusionsA significant portion of CBP patients were diagnosed with neurotic, psychosomatic, and/or depressive disorders.Antibacterial and anti–inflammatory therapy, when followed by appropriate psychotherapy and pharmacotherapy, significantly decrease the manifestations of mental disorders in CBP patients.

Effect of Urgency Symptoms on the Risk of Depression in Community-Dwelling Elderly Men

PurposeTo evaluate the association of a specific type of lower urinary tract symptom (LUTS) and the depression in community-dwelling elderly Korean men.Materials and MethodsA total of 392 men aged 65 years or older, who completed urological and psychiatric evaluations as a participant of the Korean Longitudinal Study on Health and Aging, were included. From each subject, an interview on the demographic characteristics and medical history, IPSS, and psychiatric questionnaire were taken. Subjects were divided into two groups; depression and euthymic. Subjects with IPSS subscore more than 3 points was considered 'high' subscore. IPSS subscores were compared between the two groups, and the relationship between depression and LUTS severity was assessed.ResultsThe mean age of the subjects was 75, and 6.4% of the subjects were diagnosed to have major depressive disorders. The depression group showed higher IPSS scores than the euthymic group (16.1±9.9 vs. 11.6±8.6, p=0.01). IPSS subscores of question 1 (incomplete empty), question 3 (intermittency), question 4 (urgency) and question 6 (straining to void) were higher in the depression group compared with the euthymic group. Chi-square test revealed subjects with high IPSS 1, 3, 4, and 6 score were associated with depression, but multivariate analysis identified only high IPSS question 4 as a significant prognostic factor for depression.ConclusionsElderly population with depression is more likely to have more severe LUTS than population without depression. Among the urinary symptoms, urgency was strongly associated with depression. Patients with moderate to severe LUTS and especially urgency may need their mental health status evaluation.

Suicide, an Urgent Health Issue in Korea

Suicide, an Urgent Health Issue in Korea

Mental status evaluation of patients with chronic kidney disease

Mental status evaluation of patients with chronic kidney disease

Change in sense of coherence (SOC) and symptoms of depression among old non-demented persons 12 months after hospitalization

We studied whether SOC of older adults (≥65 years) without cognitive impairment had changed 1-year after medical hospitalization (T2) and to examine what factors were associated with the change. At baseline (T1) and (T2), the 13-item version of the SOC scale assessed coping, and the Hospital Anxiety and Depression (HAD) Scale assessed symptoms of depression and anxiety. The cognitive state was assessed by means of the mini-mental state examination (MMSE). Physical health was measured with the Charlson Index and functional status with Lawton and Brody's scales for physical self-maintenance (PSMS) and the instrumental activities of daily living (I-ADL). In all, 97 (51 men) persons with a mean age of 75.3 (SD 6.3) years and Mini Mental State Evaluation (MMSE) score of 28.0 (SD 1.6) participated. The SOC improved significantly from baseline to 1-year later (mean 76.5, SD 11.4 vs. mean 79.1, SD 9.1, p≤0.01). Improved SOC was associated with a low SOC at baseline and living without assistance during the study period. The prevalence of depression (HAD-D≥8) and the mean depression (HAD-D) score did not change between the first and second data collection (HAD-D≥8: 3.1% vs. 4.1% and HAD-D score: mean 1.8, SD 2.3 vs. mean 2.4, SD 2.4). However, an improved SOC and reduced anxiety symptoms at the second time point were associated with reduced HAD-D. The mean SOC improved 1-year after hospitalization. The symptoms of depression did not change, but reduction of symptoms of depression at the second time point was associated with improved SOC.

Absence of early epileptiform abnormalities predicts lack of seizures on continuous EEG

To determine whether the absence of early epileptiform abnormalities predicts absence of later seizures on continuous EEG monitoring of hospitalized patients. We retrospectively reviewed 242 consecutive patients without a prior generalized convulsive seizure or active epilepsy who underwent continuous EEG monitoring lasting at least 18 hours for detection of nonconvulsive seizures or evaluation of unexplained altered mental status. The findings on the initial 30-minute screening EEG, subsequent continuous EEG recordings, and baseline clinical data were analyzed. We identified early EEG findings associated with absence of seizures on subsequent continuous EEG. Seizures were detected in 70 (29%) patients. A total of 52 patients had their first seizure in the initial 30 minutes of continuous EEG monitoring. Of the remaining 190 patients, 63 had epileptiform discharges on their initial EEG, 24 had triphasic waves, while 103 had no epileptiform abnormalities. Seizures were later detected in 22% (n = 14) of studies with epileptiform discharges on their initial EEG, vs 3% (n = 3) of the studies without epileptiform abnormalities on initial EEG (p < 0.001). In the 3 patients without epileptiform abnormalities on initial EEG but with subsequent seizures, the first epileptiform discharge or electrographic seizure occurred within the first 4 hours of recording. In patients without epileptiform abnormalities during the first 4 hours of recording, no seizures were subsequently detected. Therefore, EEG features early in the recording may indicate a low risk for seizures, and help determine whether extended monitoring is necessary.

Late and early onset dementia: What is the role of vascular factors? A retrospective study

BackgroundNeuropathology of Alzheimer's disease (AD) demonstrates that the common occurrence of vascular lesions and vascular factors is suggested to contribute significantly to the clinical progression of the disease. This study has assessed the presence of vascular brain lesions and risk factors in subjects with diagnosis of AD and their influence on the disease course both in Late Onset Dementia (LOD) and in Early Onset Dementia (EOD). MethodsMRI scans of 374 LOD and of 67 EOD patients were evaluated for the presence of vascular associated lesions and rated according to the age-related white matter changes (ARWMC) scale as “pure degenerative”, “mixed” and “vascular” cases of dementia. Vascular risk factors burden (hypertension, diabetes, dyslipidemia, myocardial infarction) and disease progression were also assessed. Results44% of LOD cases and 46% of EOD were classified as “mixed dementia cases”. The vascular risk factors burden showed an increase from the pure degenerative to the pure vascular forms. Disease progression, calculated in two years using the Mini Mental State Evaluation (MMSE), Activities of Daily Living (ADL) and Instrumental Activities of Daily Living (IADL) scores, did not reveal differences among the three different classes of dementias. ConclusionsVascular lesions are found in the majority of LOD cases and in about one half of EOD. This observation is consistent with the hypothesis of a synergistic effect of the degenerative and vascular factors on the development of cognitive dysfunction. The linear increase of the vascular burden supports the idea of a continuum spectrum between the pure degenerative and the pure vascular forms of adult-onset dementia disorders.

Mini mental state examination and evaluation of factors associated with cognitive decline in HIV/AIDS-infected people

Neuropsychiatric complications are present in almost one third of patients diagnosed with AIDS who show wide variations in their clinical symptoms, featuring a spectrum of disorders ranging from minor cognitive-motor impairments to profound dementia. The Mini Mental State Examination (MMSE) is one of the most used and studied cognitive tests around the world and evaluates cognitive function and screening of dementia. Current experiment applies the MMSE to HIV/AIDS patients to screen possible dementia factors in the sample and to evaluate the association of scores that are positively associated with the emergence of cognitive impairment and possible dementia. The study population consisted of 100 HIV/AIDS patients attended at the 15 th and 17 th Regional Health Centers covering 50 municipalities in the northwestern region of the state of Parana, Brazil. Whereas patients were classified with cognitive impairment and patients without cognitive impairment, the factors assessed included depression, body mass index, haematocrit, hemoglobin levels, rate of lymphocytes T CD4+, viral load and gender. Twenty-seven (27%) patients had scores lower than expected and were considered cognitively impaired. There was a significant positive association between cognitive impairment and changes in blood hemoglobin and haematocrit, age and depression.