Frailty: a new vulnerability indicator in people aging with HIV

Brothers, Thomas D.; Rockwood, Kenneth

doi:10.1007/s41999-018-0143-2

Cited by 16 publications

(26 citation statements)

References 84 publications

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“…[4][5][6] Frailty is an important emerging indicator of vulnerability that is increasingly being evaluated among individuals ageing with HIV. 7 It describes a state of physiological vulnerability that, in the presence of internal or external stressors, puts a person at an elevated risk of adverse clinical outcomes, such as hospitalisation, functional disability and mortality. 8 9 Overall, mental morbidities and frailty are understudied in the literature despite their elevated burden and potential adverse impacts on HIV treatment and health-related quality of life (HRQoL).…”

Section: Strengths and Limitations Of This Studymentioning

confidence: 99%

Mental health and well-being of older adults living with HIV in sub-Saharan Africa: a systematic review

et al. 2021

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ObjectiveIn this systematic review, we aimed to summarise the empirical evidence on common mental disorders (CMDs), cognitive impairment, frailty and health-related quality of life (HRQoL) among people living with HIV aged ≥50 years (PLWH50 +) residing in sub-Saharan Africa (SSA). Specifically, we document the prevalence and correlates of these outcomes.Design, data sources and eligibility criteriaThe following online databases were systematically searched: PubMed, CINAHL, PsycINFO, Embase and Scopus up to January 2021. English-language publications on depression, anxiety, cognitive function, frailty and quality of life among PLWH50+ residing in SSA were included.Data extraction and synthesisWe extracted information, including study characteristics and main findings. These were tabulated, and a narrative synthesis approach was adopted, given the substantial heterogeneity among included studies.ResultsA total of 50 studies from fifteen SSA countries met the inclusion criteria. About two-thirds of these studies emanated from Ethiopia, Uganda and South Africa. Studies regarding depression predominated (n=26), followed by cognitive impairment (n=13). Overall, PLWH50+ exhibited varying prevalence of depression (6%–59%), cognitive impairments (4%–61%) and frailty (3%–15%). The correlates of CMDs, cognitive impairment, frailty and HRQoL were rarely investigated, but those reported were sociodemographic variables, many of which were inconsistent.ConclusionsThis review documented an increasing number of published studies on HIV and ageing from SSA. However, the current evidence on the mental and well-being outcomes in PLWH50+ is inadequate to characterise the public health dimension of these impairments in SSA, because of heterogeneous findings, few well-designed studies and substantial methodological limitations in many of the available studies. Future work should have sufficiently large samples of PLWH50+, engage appropriate comparison groups, harmonise the measurement of these outcomes using a standardised methodology to generate more robust prevalence estimates and confirm predictors.PROSPERO registration numberCRD42020145791.

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Section: Strengths and Limitations Of This Studymentioning

confidence: 99%

Mental health and well-being of older adults living with HIV in sub-Saharan Africa: a systematic review

et al. 2021

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“…There is no consensus on the best tools to assess for frailty in older PWH [ 30 , 31 ]. The Fried frailty phenotype [ 32 ] is commonly used in HIV research and has been operationalized for clinical use [ 33 ] with 5 components (no items = robust, 1–2 = prefrail, 3–5 = frail):…”

Section: Cga Domains and Screening Methodsmentioning

confidence: 99%

Comprehensive Geriatric Assessment in Older Persons With HIV

Sangarlangkarn

Appelbaum

2020

Open Forum Infectious Diseases

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With increased longevity related to the advent of antiretroviral therapy, there are increasing proportions of older persons living with HIV (PWH). Prior studies have demonstrated increased prevalence of geriatric syndromes in older PWH and recommended the Comprehensive Geriatric Assessments (CGA) in this population. However, there is currently no peer-reviewed literature that outlines how to perform CGA in PWH in the clinical setting. In this article, we offer a review on how to perform CGA in PWH, outline domains of the CGA and their importance in PWH, and describe screening tools for each domain focusing on tools that have been validated in PWH, are easy to administer, and/or are already commonly used in the field of geriatrics

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“…The premature aging may be due to HIV disease itself, antiretroviral treatment toxicity or chronic inflammation, contributing to the phenomenon of accelerated aging [14,15]. It is also possible that the high prevalence of premature age‐related conditions is due to non‐HIV‐related factors, such as social or behavioural factors [16]. As a key contributor to poor quality of life and functional status, frailty is associated with adverse outcomes among people with HIV, including fractures, falls and mortality [16‐19].…”

Section: Introductionmentioning

confidence: 99%

“…It is also possible that the high prevalence of premature age‐related conditions is due to non‐HIV‐related factors, such as social or behavioural factors [16]. As a key contributor to poor quality of life and functional status, frailty is associated with adverse outcomes among people with HIV, including fractures, falls and mortality [16‐19]. Frailty is also associated with lower CD4 count, lower nadir CD4 count and detectable viral load [20,21].…”

Section: Introductionmentioning

confidence: 99%

Food insecurity and frailty among women with and without HIV in the United States: a cross‐sectional analysis

et al. 2021

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Introduction Frailty is frequently observed among people with HIV, and food insecurity is associated with frailty in the general population. Evidence is scarce on the associations between food insecurity and frailty among women with HIV who may be particularly vulnerable to the impacts of food insecurity. The goal of this study was to assess associations between food insecurity and frailty among women with and without HIV. Methods There were 1265 participants from the Women’s Interagency HIV Study who participated in frailty assessments in 2017. Frailty was measured using the Fried Frailty Phenotype, and women were subsequently categorized as robust, pre‐frail or frail. Food insecurity was assessed using the U.S. Household Food Security Survey Module, with women categorized as having high, marginal, low or very low food security. Multinomial logistic regression models were conducted to examine cross‐sectional associations between food insecurity and frailty while adjusting for socio‐demographic, behavioural and HIV status covariates. Results and discussion Approximately one‐third (31.9%) of the women had marginal, low or very low food security, and the proportions of women who met the criteria for frailty or pre‐frailty were 55.6% and 12.4% respectively. In the adjusted model, the relative risk ratio (RRR) of frailty for women with very low food security versus women with high food security was 3.37 (95% CI [1.38 to 8.24], p < 0.01); the corresponding RRR of pre‐frailty was 3.63 (95% CI [1.76 to 7.51], p < 0.001). Higher annual household income was associated with lower RRRs of frailty or pre‐frailty ( p < 0.01). Similarly, older age was associated with more frequent frailty (RRR=1.06, 95% CI [1.03 to 1.09], p < 0.001). HIV serostatus was not significantly associated with either pre‐frailty (RRR=0.97, 95% CI [0.71 to 1.31]) or frailty (RRR=0.75, 95% CI [0.48 to 1.16]). Conclusions Very low food security was associated with more frequent frailty and pre‐frailty among women with and without for HIV. HIV serostatus was not associated with frailty.

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Frailty: a new vulnerability indicator in people aging with HIV

Cited by 16 publications

References 84 publications

Mental health and well-being of older adults living with HIV in sub-Saharan Africa: a systematic review

Mental health and well-being of older adults living with HIV in sub-Saharan Africa: a systematic review

Comprehensive Geriatric Assessment in Older Persons With HIV

Food insecurity and frailty among women with and without HIV in the United States: a cross‐sectional analysis

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