Frailty and Pre-Frailty in a Contemporary Cohort of HIV-Infected Adults

Details

• Alternative Title:
  J Frailty Aging
• Personal Author:
  Önen, N.F. ; Patel, P. ; Baker, J. ; Conley, L. ; Brooks, J.T. ; Bush, T. ; Henry, K. ; Hammer, J. ; Kojic, E.M. ; Overton, E.T.
• Corporate Authors:
  For the Sun Study Investigators
• Description:
  Objectives
  
  To determine the prevalence of pre-frailty among HIV-infected persons and associations with pre-frailty and frailty in this population.
  
  Design, Setting and Participants
  
  From a contemporary, prospective observational cohort of HIV-infected persons (SUN Study), we determined, using a cross-sectional analytic study design, the proportions of non-frail, pre-frail, and frail persons by the respective presence of 0, 1-2, and ≥ 3 of 5 established frailty criteria: unintentional weight loss, exhaustion, physical-inactivity, weak-grip and slow-walk. We evaluated associations with pre-frailty/frailty using multivariate analysis.
  
  Results
  
  Of 322 participants assessed (79% men, 58% white non-Hispanic, median age 47 years, 95% on combination antiretroviral therapy [cART], median CD4 + cell count 641 cells/mm3 and 93% HIV RNA < 400 copies/mL), 57% were non-frail, 38% pre-frail, and 5% frail. Age increased from non-frailty through frailty. Notably, however, half of pre-frail and frail participants were < 50 years, and of those, 42% and 100%, respectively, were long-term unemployed (versus 16% of non-frail counterparts). In multivariate analysis, pre-frail/frail participants were more likely to have Hepatitis C seropositivity (adjusted odds ratio [aOR] 3.24, 95% CI: 1.35-7.78), a history of AIDS-defining-illness (aOR 3.51, 95% CI: 1.82-6.76), greater depressive symptoms (aOR 1.16, 95% CI:1.09-1.23), higher D-dimer levels (aOR 2.94, 95% CI:1.10-7.87), and were less likely to be white non-Hispanic (aOR 0.35, 95% CI: 0.20-0.61).
  
  Conclusions
  
  Pre-frailty and frailty are prevalent in the cART era and are associated with unemployment even among persons < 50 years. Pre-frailty appears to be an intermediate state in the spectrum from non-frailty through frailty and our characterization of pre-frailty/frailty suggests complex multifactorial associations.
  
  
• Subjects:
  Article Frailty HIV Human Immunodeficiency Virus Pre-frailty
• Source:
  J Frailty Aging. 3(3):158-165.
• Pubmed ID:
  27050062
• Pubmed Central ID:
  PMC5476958
• Document Type:
  Journal Article
• Funding:
  CC999999/Intramural CDC HHS/United States
• Volume:
  3
• Issue:
  3
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:f38b661a96743ce66774ea5c44897f7273380ca7eedeef537f5e099421a9a282
• Download URL:
  https://stacks.cdc.gov/view/cdc/46644/cdc_46644_DS1.pdf
• File Type:
  [PDF - 379.62 KB ]