Prevalence and risk factors of frailty among adults living with HIV aged 70 years or older

Abstract

Objectives and design:Frailty is a phenotype associated with adverse health outcomes in older persons. It has been evaluated mainly in middle-aged persons with HIV (PWH). The French multicenter prospective ANRS EP66 SEPTAVIH study aimed to assess frailty prevalence and risk factors in PWH aged 70 years or older on antiretroviral treatment (ART) for at least 12 months.Methods:At baseline, Fried frailty phenotype criteria, sociodemographic data, medical/HIV history, functional status, comorbidities, including impaired cognitive function, depression, history of falls, and co-medications were collected. We measured the prevalence of frailty and compared the characteristics of frail versus prefrail and robust participants using univariate (Kruskal–Wallis tests for continuous variables and Chi2 tests for categorical variables) and multivariate analyses.Results:Five hundred and ten PWH, mostly male (81.4%), were included with a median age of 73 years. The median HIV and ART durations were 22.7 years and 15.7 years, respectively. The prevalence of frailty was 13.5%, and of prefrailty 63.3%. In the multivariate analysis, increasing age [odds ratio (OR) 1.79 for each 5-year increment; 95% confidence interval (CI) 1.32–2.41], deprived socioeconomic status (OR 3.17; 95% CI 1.76–5.70), and multimorbidities (three or more) (OR 2.03; 95% CI 1.06–3.90) were associated with frailty.Conclusion:A low prevalence of frailty was reported (13.5%) in PWH aged 70 years or older, whereas two-thirds of them were prefrail. Age, low socioeconomic status, and multimorbidities, but no HIV-related factors, were associated with frailty, suggesting the need to target these factors to help promoting successful aging in this population.

Frailty in people 50 years or older living with HIV: A sex perspective

“…Similar to previous studies [13, 43, 44], we found that parameters linked to CD4 cells were not associated with frailty. This was not surprising, as the study population consisted of individuals on regular ART, with undetectable viral load and no active opportunistic disease.…”

Frailty and pre-frailty phenotypes increase the odds of abnormal cognitive impairment screens in people living with HIV

“…Nearly all participants assessed in the present study had virological control, and their levels of T CD4 + were high. Our cohort is representative of older PWH under efficient antiretroviral therapy in France, as assessed in the original baseline results of the SEPTAVIH study [16]. As such, our results can probably apply to PWH aged more than 70 years with efficient virological control.…”

“…Participants in this study were those included in the ANRS EP66 SEPTAVIH cohort. The ANRS EP66 SEPTAVIH cohort is a French, multicentre, prospective observational study assessing the prevalence and incidence of frailty and prefrailty in PWH aged 70 years or older as well as their predictors (Clinicaltrials.gov NCT03958786) [16]. PWH aged 70 years or older had to be on antiretroviral therapy (ART) for more than 12 months.…”

Recent advances in HIV-associated neurocognitive disorders: a focus on older adults and sub-Saharan Africa

“…An alternative approach, is the comprehensive geriatric assessment (CGA) and frailty based approach pioneered in Brighton, UK (the Silver Clinic) [42]. Frailty is increasingly recognized in individuals ageing with HIV and reported to be highly prevalent in both high income [43] and African studies [44], though one Tanzanian study reported low prevalence in a cohort with access to high quality medical care [45].…”