Physical Function and Frailty Tools in Mortality Prediction of Middle-Aged Adults With HIV

Pelloquin, Regan; Abdo, Mona; MaWhinney, Samantha; Jankowski, C.M.; Erlandson, Kristine M.

doi:10.1097/qai.0000000000002455

Cited by 14 publications

(5 citation statements)

References 35 publications

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“…A retrospective study has shown that poor physical function, falls and frailty are all predictive of mortality in middle-aged people living with HIV [68]. A systematic review noted that the predominant factors contributing to poorer physical function include HIV severity, chronic inflammation and oxidative stress, peripheral and central nervous system dysfunction and the presence of comorbidities [69 ▪▪ ].…”

Section: Physical Function and Rehabilitationmentioning

confidence: 99%

Frailty in people living with HIV: an update

Jones

Levett

Barber

2021

Current Opinion in Infectious Diseases

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Purpose of reviewThe HIV population is ageing with rising rates of frailty though strategies of how best to manage it remain ill-defined. It also remains unclear what the prevalence of frailty is within this cohort, how best to diagnose it and what factors are associated. Recent findingsThe prevalence of frailty remains unclear because of heterogenous results. Routine screening in those 50þ is recommended and whilst the Fried Frailty Phenotype is currently preferred the Clinical Frailty Scale could be considered. No biomarkers are currently recommended. Looking at associated factors, HIV neurocognitive impairment and long-term alcohol usage has been shown to be associated with developing frailty whilst those who are frail have been shown to be less active and more likely to fall. NAFLD with fibrosis has been shown to be an indicator of metabolic age and the Pooled Cohort Equations has been shown to be more effective in diagnosing cardiovascular risk in frail people living with HIV.

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Section: Physical Function and Rehabilitationmentioning

confidence: 99%

Frailty in people living with HIV: an update

Jones

Levett

Barber

2021

Current Opinion in Infectious Diseases

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“…Physical frailty is a clinical syndrome defined by five criteria—shrinking, weakness, poor endurance and energy, slowness, and low physical activity level—in which the whole is more than the sum of the parts in terms of predicting adverse health outcomes [ 12 ]. Frailty is prevalent in the older adults with HIV, is associated with mortality and is potentially reversible [ 13 – 15 ].Frailty is starting to be proposed as a clinical marker of biological age [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

Different profiles among older adults with HIV according to their chronological age and the year of HIV diagnosis: The FUNCFRAIL cohort study (GeSIDA 9817)

et al. 2022

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Background People in their fifties with HIV are considered older adults, but they appear not to be a homogeneous group. Objective To evaluate the differences among older adults with HIV according to their chronological age and the year of HIV diagnosis. Methods Cross-sectional study of the FUNCFRAIL cohort. Patients 50 or over with HIV were included and were stratified by both chronological age and the year of HIV diagnosis: before 1996 (long-term HIV survivors [LTHS]) and after 1996. We recorded sociodemographic data, HIV-related factors, comorbidities, frailty, physical function, other geriatric syndromes, and quality of life (QOL). Results We evaluated 801 patients. Of these, 24.7% were women, 47.0% were LTHS, and 14.7% were 65 or over. Of the 65 or over patients, 73% were diagnosed after 1996. Higher rates of comorbidities among LTHS were found, being the more prevalent: COPD, history of cancer, osteoarthritis, depression, and other psychiatric disorders while the more prevalent among the 65 or over patients were: hypertension, diabetes, dyslipidemia, cancer, and osteoarthritis. LTHS showed a significantly worse QOL. There were no differences by the year of HIV diagnosis regarding frailty and functional impairment (SPPB <10) but they were more than twice as prevalent in the 65 or over patients compared to the other chronological age groups. Conclusions A LTHS and a 65 or over person are both “older adults with HIV,” but their characteristics and requirements differ markedly. It is mandatory to design specific approaches focused on the real needs of the different profiles.

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“…On the other hand, measures of physical performance, including gait speed and SPPB, correlated with even more health outcome measures (Table S4) . These parameters had also been shown to predict mortality among PLWH [ 43 , 44 ]. Our findings, therefore, supported AWGS‐2019 in including the presence of either muscle strength or physical performance in the definition of sarcopenia.…”

Section: Discussionmentioning

confidence: 99%

Sarcopenia in people living with HIV in Hong Kong: which definition correlates with health outcomes?

Luk

et al. 2022

J Int AIDS Soc.

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Introduction Sarcopenia is an important clinical syndrome in older people living with HIV (PLWH). With a change to the Asia sarcopenia definition in 2019, we aimed to determine whether health outcomes were associated with different definitions of sarcopenia among Asian PLWH. Methods We performed a prospective cross‐sectional study enrolling PLWH aged ≥35 years from January 2018 to November 2021. We defined sarcopenia by the Asia Working Group of Sarcopenia (AWGS) criteria in 2014 and 2019. AWGS‐2014 included low muscle mass plus weak handgrip strength and/or slow gait speed. AWGS‐2019 included low muscle mass plus low muscle strength or physical performance, while the presence of all defines severe sarcopenia. We measured appendicular skeletal muscle mass using dual‐energy X‐ray absorptiometry, handgrip strength, usual gait speed, five‐time chair stand test and Short Physical Performance Battery. Correlations between each sarcopenia definition and health‐related quality of life (using EQ‐5D‐5L and SF‐36) and functional disability were determined. Results One hundred and fifty Asian PLWH were enrolled, 132 (88%) were male, mean age was 60±10 years, duration of HIV diagnosis was 13 (IQR 8–18) years and current CD4 count was 574 (IQR 362–762) cells/mm3, 67 (45%) had multimorbidity, 64 (43%) had polypharmacy. Prevalence of sarcopenia by AWGS‐2014, AWGS‐2019 and severe sarcopenia was 17.3%, 27.3% and 18.0%, respectively. Age, education and polypharmacy were associated with sarcopenia. Sarcopenia (AWGS‐2014) and severe sarcopenia were associated with mobility, physical functioning and physical component score (SF‐36). All three criteria were associated with impaired instrumental activities of daily living (IADL). After age and sex adjustment, sarcopenia (AWGS‐2014) (adjusted odds ratio/aOR 5.4, 95% confidence interval/CI 2.0–15.1) and severe sarcopenia (aOR 5.1, 95% CI 1.9–14.0) were associated with mobility and physical component score (SF‐36) (β coefficients –5.3342, p = 0.022 and –5.412, p = 0.019). Sarcopenia (AWGS 2014) (aOR 5.2, 95% CI 1.7–16.2), sarcopenia (AWGS‐2019) (aOR 4.5, 95% CI 1.5–13.1) and severe sarcopenia (aOR 3.5, 95% CI 1.1–10.9) were associated with impaired IADL in fully adjusted models. Conclusions In a sample of Asian PLWH, 17.3%, 27.3% and 18.0% had sarcopenia as defined by AWGS‐2014, AWGS‐2019 and severe sarcopenia, respectively. Sarcopenia by AWGS‐2014 and severe sarcopenia correlated with parameters of poor health outcomes, while sarcopenia by AWGS‐2019 correlated with functional disability.

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Physical Function and Frailty Tools in Mortality Prediction of Middle-Aged Adults With HIV

Cited by 14 publications

References 35 publications

Frailty in people living with HIV: an update

Frailty in people living with HIV: an update

Different profiles among older adults with HIV according to their chronological age and the year of HIV diagnosis: The FUNCFRAIL cohort study (GeSIDA 9817)

Sarcopenia in people living with HIV in Hong Kong: which definition correlates with health outcomes?

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