Biologic aging, frailty, and age-related disease in chronic HIV infection

Brothers, Thomas D.; Rockwood, Kenneth

doi:10.1097/coh.0000000000000070

Cited by 56 publications

(49 citation statements)

References 76 publications

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“…The prevalence of frailty observed in these studies is similar to or higher than that seen in the Cardiovascular Health Study (12%) and the Women's Health and Aging Study (11%), even though the average ages of the VACS and MACS study populations are much younger . Frailty has been associated with HIV infection; HIV‐associated factors such as duration of chronic infection, lipodystrophy, and fatigue; and other factors such as race, ethnicity, and socioeconomic status. Frailty also predicts mortality and hospitalizations in HIV‐infected adults .…”

Section: Frailty and Hivsupporting

confidence: 56%

Integrating Frailty Research into the Medical Specialties—Report from a U13 Conference

Walston

Robinson

Zieman

et al. 2017

J American Geriatrics Society

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Although the field of frailty research has expanded rapidly, it is still a nascent concept within the clinical specialties. Frailty, conceptualized as increased vulnerability to stressors because of significant depletion of physiological reserves, predicts poorer outcomes in several medical specialties, including cardiology, HIV care, nephrology, and in the behavioral and social sciences. Incorporation of frailty assessment and frailty research into the specialties is hindered by a lack of a consensus definition, by the proliferation of measurement tools, inadequate understanding of the biology of frailty, and lack of validated clinical algorithms for patients who have frailty. In 2015, the American Geriatrics Society, the National Institute on Aging (NIA) and the Alliance for Academic Internal Medicine held a conference for awardees of the NIA sponsored ‘Grants for Early Medical/Surgical Specialists Transition into Aging Research (GEMSSTAR)’1 program to review the current state of the knowledge regarding frailty in the sub-specialties, as well as to highlight key examples of integrating frailty research into the medical specialties. Key research questions to advance frailty research into specialty medicine are proposed.

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Section: Frailty and Hivsupporting

confidence: 56%

Integrating Frailty Research into the Medical Specialties—Report from a U13 Conference

Walston

Robinson

Zieman

et al. 2017

J American Geriatrics Society

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“…Frailty has been proposed as a useful marker of overall biological health and aging in this context, especially among people with immune recovery and suppressed viral loads. 9,12 As frailty is a holistic measure of health, it might be able to more sensitively discriminate risk among people aging with HIV than individual disease markers or comorbidity diagnoses. 12 Although early cross-sectional data have associated frailty with vulnerability for multimorbidity and mortality among people with HIV, 13 the relationship between frailty and cognitive aging has not yet been established.…”

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confidence: 99%

Lower Frailty Is Associated with Successful Cognitive Aging Among Older Adults with HIV

Wallace

Ferrara

Garlassi

et al. 2017

AIDS Research and Human Retroviruses

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Aging with HIV poses unique and complex challenges, including avoidance of neurocognitive disorder. Our objective here is to identify the prevalence and predictors of successful cognitive aging (SCA) in a sample of older adults with HIV. One hundred three HIV-infected individuals aged 50 and older were recruited from the Modena HIV Metabolic Clinic in Italy. Participants were treated with combination antiretroviral therapy for at least 1 year and had suppressed plasma HIV viral load. SCA was defined as the absence of neurocognitive impairment (as defined by deficits in tasks of episodic learning, information processing speed, executive function, and motor skills) depression, and functional impairment (instrumental activities of daily living). In cross-sectional analyses, odds of SCA were assessed in relation to HIV-related clinical data, HIV-Associated Non-AIDS (HANA) conditions, multimorbidity (≥2HANA conditions), and frailty. A frailty index was calculated as the number of deficits present out of 37 health variables. SCA was identified in 38.8% of participants. Despite no differences in average chronologic age between groups, SCA participants had significantly fewer HANA conditions, a lower frailty index, and were less likely to have hypertension. In addition, hypertension (odds ratio [OR] = 0.40, p = .04), multimorbidity (OR = 0.35, p = .05), and frailty (OR = 0.64, p = .04) were significantly associated with odds of SCA. Frailty is associated with the likelihood of SCA in people living with HIV. This defines an opportunity to apply knowledge from geriatric population research to people aging with HIV to better appreciate the complexity of their health status.

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“…48 The biologic syndrome of frailty due to advanced chronologic age has less hope as a target to reverse the clinical detriments of frailty. In contrast, frailty due to a specific underlying cause that can be reversed appears to be a more fruitful target for interventions.…”

Section: Frailty Accelerators Beyond Agementioning

confidence: 99%

Frailty for Surgeons: Review of a National Institute on Aging Conference on Frailty for Specialists

Robinson

Walston

Brummel

et al. 2015

Journal of the American College of Surgeons

237

172

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Biologic aging, frailty, and age-related disease in chronic HIV infection

Abstract: Age-related deficit accumulation is influenced by both the background or environmental rate of insults an organism sustains and the efficacy of intrinsic damage control and repair mechanisms. Both processes are likely affected in people living with HIV infection.

Cited by 56 publications

References 76 publications

Integrating Frailty Research into the Medical Specialties—Report from a U13 Conference

Integrating Frailty Research into the Medical Specialties—Report from a U13 Conference

Lower Frailty Is Associated with Successful Cognitive Aging Among Older Adults with HIV

Frailty for Surgeons: Review of a National Institute on Aging Conference on Frailty for Specialists

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