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

Abstract

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.

Harvard HIV and Aging Workshop: Perspectives and Priorities from Claude D. Pepper Centers and Centers for AIDS Research

“…However, using accelerometry in a follow-up study, volitional gait speed by activity tracker was significantly reduced compared to the uninfected participants. 26,27 Consistent with this observation, male PWH spent significantly more time in the lowest quartile of PA compared to the seronegative controls. 26 Collectively, asymptomatic PWH on effective ART were characterized by subclinical deficits in physical function, greater levels of fatigue and estimated mortality risk (by the VACS Index), elevated inflammation and immune activation, and increased skeletal muscle internalized nuclei with decreased PGC-1a.…”

“…26,27 Consistent with this observation, male PWH spent significantly more time in the lowest quartile of PA compared to the seronegative controls. 26 Collectively, asymptomatic PWH on effective ART were characterized by subclinical deficits in physical function, greater levels of fatigue and estimated mortality risk (by the VACS Index), elevated inflammation and immune activation, and increased skeletal muscle internalized nuclei with decreased PGC-1a. Differences by HIV serostatus on volitional but not laboratory-based gait measures and activity profiles characterized by more time spent at lower activity levels suggest potential limits on functional reserve.…”

“…Summary data were presented on emerging deficits in function in middle-aged PAWH. 26,27 Jennifer Schrack discussed energy expenditure and aging and presented data that profiled HIV-related decline in aerobic capacity with age and increasing burden of multimorbidity on energy reserves and metabolism. 24,28,29 Summary data indicated that PWH have higher resting metabolic rates, slower peak and usual walking speed, lower aerobic capacity, and lower physical activity (PA).…”

Reduced Levels of NAD in Skeletal Muscle and Increased Physiologic Frailty Are Associated With Viral Coinfection in Asymptomatic Middle-Aged Adults

“…The participants in this study have been previously described. 7 , 17 , 18 In brief, the cohort consists of asymptomatic adults living with HIV infection on effective antiretroviral therapy and individuals without infection, both men and women, all aged between 50 and 65 years. This substudy consists of participants with skeletal muscle biopsy specimens (n = 54).…”

“…The Muscle and Aging in Treated Chronic HIV infection (MATCH) study has been described elsewhere. 7 , 17 , 18 In brief, it is a prospective observational study conducted at Brigham and Women's Hospital in Boston, MA (clinical trials registration no. NCT03011957).…”