Prevalence of Frailty and Prefrailty in People With Human Immunodeficiency Virus Aged 50 or Older: A Systematic Review and Meta-Analysis

Abstract

Background With effective antiretroviral therapy, there is an emerging population of adults aged 50 years or older with human immunodeficiency virus (HIV). Frailty is an increasingly recognized clinical state of vulnerability associated with disability, hospitalization, and mortality. However, there is a paucity of large studies assessing its prevalence in people with HIV (PWH) aged 50 or older. Methods PubMed was systematically searched for studies published between January 2000 and August 2020 reporting the prevalence of frailty in PWH aged 50 or older. The pooled prevalence of frailty and prefrailty was synthesized using a random-effects meta-analysis. Results Of the 425 studies identified, 26 studies were included in the analysis, with a total of 6584 PWH aged 50 or older. The included studies were published between 2012 and 2020, and all studies used the Fried frailty phenotype to define frailty. The overall pooled prevalence of frailty and prefrailty was 10.9% (95% confidence interval [CI], 8.1%–14.2%) and 47.2% (95% CI, 40.1%–54.4%), respectively. A high degree of heterogeneity was observed (I2 = 93.2%). In the subgroup analysis, HIV-related variables and other demographic variables were examined, and heterogeneity disappeared only in the group of a longer duration since HIV diagnosis (I2 = 0%). Conclusions The pooled prevalence of frailty and prefrailty defined by the Fried frailty phenotype was assessed in PWH aged 50 or older. Findings from this study quantified the proportion of this specific population with this common geriatric syndrome. Future studies identifying effective strategies for frailty screening and intervention are required for this vulnerable population.

Factors Related to Multidimensional Frailty Among Hispanic People Living With HIV Aged 50 Years and Above: A Cross-sectional Study

“…Within the fields of geriatrics and HIV, the most common way to define frailty is based on the Fried Frailty Phenotype (FFP), which identifies frail individuals as those with at least three of the following characteristics: exhaustion, reduced muscle strength, low physical activity, slow walking speed, and unintentional weight loss (Fried et al, 2001). The prevalence of frailty among PLWH aged 50 years and above in a recent systematic review and meta-analysis ranges from 8.1% to 14.2% (Yamada et al, 2022). In addition, the onset of frailty is nearly 10 years earlier in PLWH compared with those without HIV (Desquilbet et al, 2007; Levett et al, 2016).…”

Characterization of data-driven geriatric syndrome clusters in older people with HIV: a Mexican multicenter cross-sectional study

“… 21 , 22 , 23 The observed frailty prevalence in this study is lower in comparison to what is reported by two systematic reviews on the subject: the most recent being by Yamada and collaborators reporting a pooled prevalence of 10.9%. 24 , 25 However, when contextualizing the observed results, it is important to consider that this comparatively lower prevalence of frailty has already been reported in another Mexican study. 22 Nevertheless, other findings such as the observed prevalence of disability for mobility, multimorbidity, as well as a very low proportion of participants without any GS, are still remarkable, as this remains a relatively young population.…”

Frailty and prefrailty in people living with HIV, with focus on women living with HIV

“…Studies show that frailty and prefrailty appear more often and at an earlier age in people living with HIV than in the general population and can reach up to 28.6% and 47.2% respectively. 8,[13][14][15] This can be explained by several factors including the persistent chronic inflammation caused by HIV, other HIV-related factors such as low CD4 cell count, higher rates of comorbidities (eg. cardiovascular, metabolic, osteoporosis) than in the general population, as well as higher rates of smoking and intravenous drug use (IDU) among PLWH.…”