Geriatric syndromes

Hawkins, Kellie; Brown, Todd T.; Margolick, Joseph B.; Erlandson, Kristine M.

doi:10.1097/qad.0000000000001444

Cited by 60 publications

(31 citation statements)

References 117 publications

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“…These alterations are also observed in the elderly, overall defining the conditions of "immunosenescence" and "inflammaging" [13]. Immune activation in PLWH may result from the persistence of HIV infection in latently infected cells, but other factors are likely to contribute, including cART, risk behaviours, e.g., smoking or use of drugs, and other comorbidities [14]. In turn, chronic inflammation is one of the most important risk factors for the developing of non-AIDS diseases, including cardiovascular, kidney or liver disease, cancers, some neurological diseases and "geriatric syndromes", including sarcopenia, frailty and falls [15].…”

Section: Mechanisms Of Sarcopenia In People Living With Hivmentioning

confidence: 99%

The Role of Physical Activity for the Management of Sarcopenia in People Living with HIV

Bonato

Turrini

Galli

et al. 2020

IJERPH

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Sarcopenia is a physiopathological process associated with aging, caused by reduction of muscle strength, muscle quality and physical performance, and associated with an increased risk of falls, physical disability and premature death. There is no effective treatment for sarcopenia, but physical exercise seems to be highly effective at counteracting the decline in muscle mass and strength associated with aging. Recently, sarcopenia has been recognized as an emerging issue in people living with HIV (PLWH). Despite adequate treatment with combination antiretroviral therapy (cART), PLWH may exhibit an early occurrence of some aging-related conditions, including sarcopenia, frailty and falls, and this is likely resulting from high rates of comorbidities, high-risk behaviours, chronic immune activation and cART-specific factors. In this review, we discuss the potential mechanisms and the clinical relevance of sarcopenia in PLWH, and present data from longitudinal studies of physical activity in this population. Despite none of these studies having specifically addressed the benefits of physical exercise on sarcopenia, there is evidence that exercise is effective to increase aerobic capacity and muscle strength, and to improve body composition and inflammatory outcomes in PLWH. Therefore, the expected benefits of physical exercise are likely to translate into a successful and specific intervention for prevention and treatment of sarcopenia in this population.

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Section: Mechanisms Of Sarcopenia In People Living With Hivmentioning

confidence: 99%

The Role of Physical Activity for the Management of Sarcopenia in People Living with HIV

Bonato

Turrini

Galli

et al. 2020

IJERPH

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“…Despite the success of combination antiretroviral therapy (ART) in achieving durable virologic suppression, people with HIV (PWH) are at increased risk for multiple comorbidities associated with aging in the general population, including cardiovascular disease (CVD), lung disease, liver disease, kidney disease, diabetes, neurocognitive disorders, decreased bone mineral density, malignancies, and other diseases [ 1 ]. Evidence suggests that treated HIV infection is associated with accentuated aging phenotypes, and these age-related comorbidities can occur at younger ages [ 2 , 3 ]. The pathophysiologic mechanisms that drive biological aging and age-related comorbidities are not well understood, and the impact of HIV and ART on the biology of aging remains poorly defined.…”

Section: Introductionmentioning

confidence: 99%

Pathogenesis of Aging and Age-related Comorbidities in People with HIV: Highlights from the HIV ACTION Workshop

Gabuzda

Jamieson

Collman

et al. 2020

PAI

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People with HIV (PWH) experience accentuated biological aging, as defined by markers of inflammation, immune dysfunction, and the epigenetic clock. They also have an elevated risk of multiple age-associated comorbidities. To discuss current knowledge, research gaps, and priorities in aging and age-related comorbidities in treated HIV infection, the NIH program staff organized a workshop held in Bethesda, Maryland in September 2019. This review article describes highlights of discussions led by the Pathogenesis/Basic Science Research working group that focused on three high priority topics: immunopathogenesis; the microbiome/virome; and aging and senescence. We summarize knowledge in these fields and describe key questions for research on the pathogenesis of aging and age-related comorbidities in PWH. Understanding the drivers and mechanisms underlying accentuated biological aging is a high priority that will help identify potential therapeutic targets to improve healthspan in older PWH.

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“…Survival for people aging with HIV (PAWH) is now approaching the lifespan of uninfected individuals, in part, owing to the success of effective antiretroviral therapy [1]. In developed countries, more than half of the PAWH are over 50 years old and may be at greater risk for age-related comorbidities, including a decline in functional capacity [2]. Why these age-related comorbidities more often occur at younger ages in PAWH compared with uninfected (HIV−) individuals is presently unclear [3].…”

Section: Introductionmentioning

confidence: 99%

Middle-Aged Men With HIV Have Diminished Accelerometry-Based Activity Profiles Despite Similar Lab-Measured Gait Speed: Pilot Study

Hale

Guardigni

Roitmann³

et al. 2019

JMIR Mhealth Uhealth

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Background People aging with HIV are living with increased risk for functional decline compared with uninfected adults of the same age. Early preclinical changes in biomarkers in middle-aged individuals at risk for mobility and functional decline are needed. Objective This pilot study aims to compare measures of free-living activity with lab-based measures. In addition, we aim to examine differences in the activity level and patterns by HIV status. Methods Forty-six men (23 HIV+, 23 HIV−) currently in the MATCH (Muscle and Aging Treated Chronic HIV) cohort study wore a consumer-grade wristband accelerometer continuously for 3 weeks. We used free-living activity to calculate the gait speed and time spent at different activity intensities. Accelerometer data were compared with lab-based gait speed using the 6-minute walk test (6-MWT). Plasma biomarkers were measured and biobehavioral questionnaires were administered. Results HIV+ men more often lived alone ( P =.02), reported more pain ( P =.02), and fatigue ( P =.048). In addition, HIV+ men had lower blood CD4/CD8 ratios ( P <.001) and higher Veterans Aging Cohort Study Index scores ( P =.04) and T-cell activation ( P <.001) but did not differ in levels of inflammation ( P =.30) or testosterone ( P =.83). For all participants, accelerometer-based gait speed was significantly lower than the lab-based 6-MWT gait speed ( P <.001). Moreover, accelerometer-based gait speed was significantly lower in HIV+ participants ( P =.04) despite the absence of differences in the lab-based 6-MWT ( P =.39). HIV+ participants spent more time in the lowest quartile of activity compared with uninfected ( P =.01), who spent more time in the middle quartiles of activity ( P =.02). Conclusions Accelerometer-based assessment of gait speed and activity patterns are lower for asymptomatic men living with HIV compared with uninfected controls and may be useful as preclinical digital biomarkers that precede differences captured in lab-based measures.

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Geriatric syndromes

Cited by 60 publications

References 117 publications

The Role of Physical Activity for the Management of Sarcopenia in People Living with HIV

The Role of Physical Activity for the Management of Sarcopenia in People Living with HIV

Pathogenesis of Aging and Age-related Comorbidities in People with HIV: Highlights from the HIV ACTION Workshop

Middle-Aged Men With HIV Have Diminished Accelerometry-Based Activity Profiles Despite Similar Lab-Measured Gait Speed: Pilot Study

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