BackgroundIn the current two decades, dyslipidemia and increased blood glucose as metabolic abnormalities are the most common health threats with a high incidence among HIV/AIDS patients on antiretroviral (ARV) treatment. Scientific investigations and reports on lipid and glucose disorders among HIV infected communities are inadequate especially in those developing such as Malaysia. This cross-sectional survey was mainly aimed to evaluate the prevalence of metabolic abnormalities and associated risk factors among HIV infected population patients on ARV medication.MethodsIn a single reference health center in Malaysia, 2739 adult HIV positive patients on antiretroviral therapy (ART) were studied cross-sectionally using medical records. Besides demographic variables and associated health disorders, those factors which can change the lipid and glucose levels were collected. Logistic Regression was used to find the potential risk factors (p < 0.05).ResultsMajority of the studied population were male (81.1%) and aged between 30–49 (68.6%). Mean CD4 count was 474.25 (cells/mm3) while undetectable RNA viral load was common among 83.3 (%) of subjects. Among 1,583 patients with the recent blood lipid and glucose tests, increased levels of triglyceride (TG) and total cholesterol (TC) were frequently prevalent in half of the population as 59 (%) and 54.2 (%) while 28.7 (%), 35.1 (%) and 38.2 (%) had declined level of high-density lipoprotein (HDL), raised low-density lipoprotein (LDL) and fasting plasma glucose (FPG) which were less common. Dyslipidemia was common in 82.3 (%) of the subjects. Notably, medication with protease inhibitor (PI) was a potential risk for elevated triglyceride (odds ratio (OR) = 2.309, 95% confidence interval (CI) = 1.605–3.324, P = 0.001), high TC (OR = 1.561, 95% CI = 1.123–2.169, P = 0.008) and low HDL (OR = 1.449, 95% CI = 1.037–2.024, P = 0.029). As lifestyle factor, alcohol consumption results as significant risk factor for raised TG (OR = 2.653, 95% CI = 1.353–5.202, P = 0.004). Also having hepatitis raised risk of high FPG level (OR = 1.630, 95% CI = 1.197-2.220, P = 0.002) in this sample population.ConclusionsDyslipidemia is highly common in Malaysian HIV subjects receiving ARV medication. Lifestyle modification, changing PI and switch to other ARV regimen can help in reduction of these abnormalities. Also suitable strategies and plans are necessary to prevent cardiovascular diseases in future.

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BACKGROUND Older adults are vulnerable towards cognitive frailty that can lead to adverse health outcomes such as cognitive frailty, falls, disabilities, hospitalizations and increased morbidity. With advancement of healthcare technology, there is a potential to manage and reverse cognitive frailty among older adults using a multi-domain intervention programme via telerehabilitation. OBJECTIVE In this review, we aimed to identify the feasibility and acceptance towards telerehabilitation and the common technology used for delivering telerehabilitation among older adults with mild cognitive impairment or cognitive frailty. METHODS Five research databases were searched: PubMed (EMBASE), Embase (Science Direct), Cochrane Database of Systematic Review, IEEE Xplore and Scopus. Articles published from January 2015 until October 2020 were selected. A hand search of JMIR Publications journals was also included RESULTS Of the 1758 articles retrieved, six studies were identified that involved implementation of telerehabilitation targeting older adults with cognitive frailty. Two articles were randomized controlled trials, one pilot study and three were qualitative studies. Telerehabilitation can improve quality of life among participants with mild cognitive impairment and cognitive frailty and found to be feasible as supportive digital platform in digital health care. Some types of technologies commonly used in the studies were smartphone or telephone with Internet, television-based assistive integrated technology, mobile application and videoconference. CONCLUSIONS Telerehabilitation utilization in managing cognitive frailty among older adults is still limited and more research is required to evaluate its feasibility and acceptability. Although telerehabilitation appears to be feasible and accepted among older adults with cognitive frailty, some social support in place is required. Future research should focus on evaluation of acceptance and cost effectiveness of multi-domain intervention via telerehabilitation among older adults with cognitive frailty.