Decline in locomotor functions over time in HIV-infected patients

Richert, Laura; Brault, Mathilde; Mercié, P.; Dauchy, Frédéric‐Antoine; Bruyand, Mathias; Greib, C.; Dabis, François; Bonnet, Fabrice; Chêne, Geneviève; Dehail, Patrick; Aquitaine, Groupe d’Epidémiologie Clinique du Sida en

doi:10.1097/qad.0000000000000246

Cited by 48 publications

(63 citation statements)

References 35 publications

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“…The characteristics of our population differed from those of Richert et al [5]. Our sample was predominantly female (67.53%) and the median age was 45.4 years, whereas the Bordeaux team studied a group consisting of 80% men with a median age of 47.6 years (IQR=41.8-53.9) [5,13,14]. Most studies show that the prevalence of these disorders is directly related to age [2,9,10].…”

Section: Discussioncontrasting

confidence: 43%

“…We therefore found a significant association between performance in the "five-times sit-to-stand" test and duration of HIV infection, but no relation with either immuno-virological characteristics nor duration of exposure to antiretrovirals [12,14]. Richert et al found that age, the presence of diabetes, cerebral complications related to AIDS and drug use were risk factors for the development of locomotors disorders [13].…”

Section: Discussionmentioning

confidence: 97%

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Aging with HIV Infection and Locomotors Disorders: Experience of the Infectious and Tropical Diseases Unit, Abidjan, Côte d’Ivoire

Tanon¹,

Diallo²,

Lenaud³

et al. 2017

J AIDS Clin Res

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Objective: The aim of the study was to estimate the prevalence of locomotor disorders among people living with HIV in Abidjan. Methods:A cross-sectional study was conducted in April-July 2014 at the Department of Infectious and Tropical Diseases in Abidjan. Data were collected with a questionnaire and four tests of locomotor function: 4-m walking speed, five timings from sit-to-stand, the timed "up and go" test and standing on one leg with the eyes closed. Logistic regression models were used to find factors associated with locomotors disorders. Results:Of the 308 patients included in our study, 67.5% were women, and the median age was 45 years. The median duration of HIV infection was 91 months, and 97.4% were receiving antiretroviral therapy. The locomotor test that showed the most frequent alteration (87% of patients) was standing on one leg with the eyes closed. The prevalence of locomotors disorders was estimated to be 34% (95% confidence interval (CI), 28.8-39.4). In the multivariate analysis, age (odds ratio (OR), 1.9; 95% CI, 1.1-3.2; p=0.014) and body mass index (OR, 2.5; 95% CI, 1.5-4.3; p=0.001) were significantly associated with the presence of locomotors disorders. No association was found with time since diagnosis of HIV infection or antiretroviral therapy. Conclusion:The prevalence of locomotors disorders among people living with HIV is high. Strategies should be developed to screen and treat these disorders in order to limit functional impairment in this population.

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Section: Discussioncontrasting

confidence: 43%

Section: Discussionmentioning

confidence: 97%

Aging with HIV Infection and Locomotors Disorders: Experience of the Infectious and Tropical Diseases Unit, Abidjan, Côte d’Ivoire

Tanon¹,

Diallo²,

Lenaud³

et al. 2017

J AIDS Clin Res

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“…In this study, HIV-infected older persons on virologically suppressive antiretroviral therapy demonstrated significantly diminished physical function compared to similarly aged persons without HIV infection, putting them at risk for falls and mobility-related disability [26–28]. …”

Section: Discussionmentioning

confidence: 99%

Diminished physical function in older HIV-infected adults in the Southeastern U.S. despite successful antiretroviral therapy

et al. 2017

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BackgroundAs antiretroviral therapy efficacy improves, HIV is gradually being recognized more as a chronic disease within the aging HIV-infected population. While these individuals are surviving into old age, they may, however, be experiencing “accelerated aging” with greater declines in physical function than that observed among comparably matched individuals free of HIV. This decline is not well understood and it remains unclear if physical decline correlates with the degree of immunosuppression based on CD4 lymphocyte nadir.MethodsIn a cross-sectional study of accelerated aging in the older HIV-infected population on antiretroviral therapy (ART), physical performance evaluations were completed on a cohort of 107 HIV-infected subjects, age 50 years or older (with no HIV-1 RNA >200 copies/mL in the prior 12 months), and compared to reference ranges for age- and gender-matched HIV-uninfected persons. Physical performance testing consisted of four validated assessments: the 2.4-meter walk, 30-second chair stand, grip strength and 6-minute walk test.ResultsWhen compared to age- and gender-matched HIV-uninfected reference controls, older HIV-infected persons had diminished physical function. No correlation was found between physical function and degree of immunosuppression as determined by pre-ART CD4 nadir.ConclusionsDespite improved survival, HIV–infected adults on suppressive ART have diminished physical function compared to HIV-uninfected persons. The degree of HIV-associated immunosuppression does not correlate with the observed degree of physical function decline in older HIV-infected persons, suggesting the decline is mediated by other mechanisms.

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“…Recent evidence suggests that impaired locomotor function, as determined by routine functional tests of the lower extremities, is both common and increases over time in older HIV patients with comorbidities [92, 93]. This is an important risk for falls and interacts closely with the decline in gait speed which also occurs in older HIV patients [94].…”

Section: Frailty and Physical Function Impairment As Risks For Low Bmmentioning

confidence: 99%

More than osteoporosis

Erlandson

Guaraldi

Falutz

2016

Current Opinion in HIV and AIDS

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Purpose of Review The interaction between fall and fracture risk factors is an area of increasing clinical relevance, but little is known about the age-specific issues in bone health unique to HIV-infected adults. This review will focus on what is known about falls and fall risk factors among HIV-infected adults, and then review the association between decreased muscle, increased adiposity, and frailty with both low BMD and falls Recent Findings The rate of falls among middle-aged HIV-infected adults is similar to that of HIV-uninfected adults 65 years and older. Many of the clinical factors that contribute to low BMD overlap with risk factors for falls, resulting in a high risk of a serious fall among older adults with the greatest risk for a fracture. Low muscle mass, increased adiposity and metabolic syndrome, physical function impairment and frailty, common among older HIV-infected adults, contribute to an increased risk for low BMD and falls, and subsequently, may increase the risk of fracture among HIV-infected older adults. Summary Interventions with dual benefit on reducing fall risk and improving BMD are likely to have the greatest impact on fracture prevention in the older, HIV-infected adult.

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Decline in locomotor functions over time in HIV-infected patients

Cited by 48 publications

References 35 publications

Aging with HIV Infection and Locomotors Disorders: Experience of the Infectious and Tropical Diseases Unit, Abidjan, Côte d’Ivoire

Aging with HIV Infection and Locomotors Disorders: Experience of the Infectious and Tropical Diseases Unit, Abidjan, Côte d’Ivoire

Diminished physical function in older HIV-infected adults in the Southeastern U.S. despite successful antiretroviral therapy

More than osteoporosis

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