Trastornos neurocognitivos asociados al VIH en adultos mayores frágiles: revisión narrativa en el contexto latinoamericano

Objective: The study aimed to synthesize the available evidence on HIV-associated neurocognitive disorders in older adults with frailty in the Latin American context, considering its relevance for a comprehensive clinical approach. Methodology: A narrative review was conducted through a literature search in PubMed, SciELO, Scopus, DIALNET, and LILACS, with no language restrictions, prioritizing publications from 2018 to 2025. DeCS/MeSH descriptors and Boolean operators (AND, OR) were used. In addition, references were managed in Mendeley, and the methodological quality of the included studies was assessed using the SANRA scale. Results: Of the 53 initial records, 21 studies were included. In Latin American populations without HIV screening, a significant baseline burden of cognitive impairment was described in vulnerable settings. While higher prevalences of HAND were reported in older adults with HIV, mild or asymptomatic forms predominated. Additionally, a complex clinical relationship was observed between frailty, prefrailty, and cognitive performance, modulated by factors such as low educational attainment, comorbidities, depressive symptoms, and polypharmacy. Conclusions: The reviewed evidence supported the inclusion of mental skills tests and frailty assessment, highlighting prefrailty as a risk indicator. It also suggested the need for multidisciplinary strategies tailored to Latin America to maintain autonomy and quality of life.