Frailty Phenotype: A Clinical Marker of Age Acceleration in the Older HIV-Infected Population

Abstract

Aim: To evaluate the association between DNA methylation and frailty in the HIV-infected population and to investigate the usefulness of assessing frailty as a clinical marker to identify age acceleration. Methods: Frailty was assessed according to Fried's frailty phenotype. DNA methylation was analyzed in 10 frail patients, and compared with 10 robust control patients, all with HIV. Predicted age was inferred using the Weidner's formula. Age acceleration was assessed using the difference between predicted and chronological age. Results: HIV-infected frail patients had significantly higher biological predicted ages than chronological ages (mean acceleration: 10.3 years; p = 0.012). Conclusions: We link age acceleration and frailty in an older HIV population. Frailty could be used in this population for implementing specific clinical approaches.

Envejecimiento y Fragilidad en el paciente con infección por VIH

“…Giovanni Dolci [1], Jovana Milic [3], Federica Carli [1], Cristina Mussini [1] podrían ser otros o por qué no la epigenética [55]. Quizá, pruebas de esfuerzo sencillas como la velocidad de la marcha, el SPPB o los test de depresión de Yesavage, test nutricionales (mini nutritional assessment-MNA), o fenotipos o índices de fragildiad aporten mucha más información pronóstica que los clásicos CD4 y CV.…”

DNA methylation biomarker selected by an ensemble machine learning approach predicts mortality risk in an HIV-positive veteran population

“…DNAm age is significantly correlated with physical frailty in HIV-negative individuals (28) and HIV-positive individuals (29). In HIV-positive individuals, the average DNAm age is accelerated 5 to 10 years faster than HIV-negative individuals (30)(31)(32)(33) and 10 years faster in the HIV-positive frailty individuals in comparing to HIV-positive non-frailty individuals (29). These age-related DNAm signatures are predictive of mortality (34)(35)(36)(37)(38).…”

“…Furthermore, aging, a critical contributor to frailty, is significantly associated with thousands of CpGs in the epigenome, and the epigenetic clock and DNAm age are becoming widely recognized (7)(8)(9). DNAm age is significantly correlated with physical frailty in HIV-negative individuals (28) and HIV-positive individuals (29). In HIV-positive individuals, the average DNAm age is accelerated 5 to 10 years faster than HIV-negative individuals (30)(31)(32)(33) and 10 years faster in the HIV-positive frailty individuals in comparing to HIV-positive non-frailty individuals (29).…”

Commentary: Impact of new hypertension guideline among people living with HIV in Ghana

“…In addition, the clinical signs of frailty—slowness, loss of muscle strength, low level of physical activity and energy, and wasting—resemble to symptoms observed among PLWH. A large body of empirical evidence suggests that PLWH have an accelerated aging process and HIV infection is associated with premature development of frailty . The prevalence of frailty among HIV‐infected patients is much higher than the general population …”

“…A large body of empirical evidence suggests that PLWH have an accelerated aging process and HIV infection is associated with premature development of frailty. [4][5][6] The prevalence of frailty among HIV-infected patients is much higher than the general population. 7 The appropriate treatment of hypertension among older adults, especially those who are very old or frail, has been hotly debated.…”