Race Against Dementia Associate Fellow
University of Cape Town
Sam Nightingale is an Associate Professor of Neurology at the University of Cape Town. After training in the UK, Sam became interested in brain infections and global neurology.
He has established a new framework to categorise cognitive impairment in people with HIV, chairs the International HIV-Cognition Working Group and is PI for the CONNECT study, investigating a large cohort of people with HIV in Cape Town. He is particularly interested in what the study of ageing HIV sufferers reveal about the mechanisms underlying Alzheimer’s disease.
The cause of Alzheimer’s disease is still not known. Amyloid protein accumulates in the brain of those with Alzheimer’s disease, however it is not known why the body produces amyloid. Whilst not yet proven, it has been proposed that amyloid is a response to inflammation and infection in our brains, trying to patch up damaged areas as we grow older. Examining older people with HIV will provide a unique opportunity to test this theory.
Following the remarkable success of antiretroviral treatment, people with HIV are now living into older age (5% of people over 70 years old in some areas of South Africa live with HIV). HIV can affect the brain, leading to chronic inflammation. It is not yet known whether this leads to a higher risk of Alzheimer’s disease for older people living with HIV. If it does, this suggests something important about the cause of Alzheimer’s disease, which could lead to its treatment or prevention.
Sam has designed a study of 250 people over the age of 70. Half will be people living with HIV and the other half will be HIV-negative people from a similar background. The hypothesis is that those with HIV will have more amyloid protein in the brain as indicated by spinal fluid tests, and a higher risk of Alzheimer’s disease.