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

Abstract

ObjectiveTo estimate prefrailty and frailty prevalence and associated factors in people living with HIV (PLHIV) from a sex perspective.MethodsCross‐sectional study on PLHIV at specialized public health centres in Brazil. Data were obtained from individuals aged ≥50 years using antiretroviral therapy (ART) and with an undetectable viral load through personal interviews, clinical evaluations and medical records. Frailty and prefrailty were characterized using the Fried Frailty Phenotype tool. Multinomial regression models were performed, and the associated factors were selected through the backward stepwise method.ResultsAmong 670 patients, 373 men and 297 women were included. The prevalence of frailty and prefrailty was significantly higher for women (16.2% and 56.2%, respectively) than for men (11.5% and 46.4%, respectively). Low socioeconomic and educational level, multimorbidity, depression, subjective cognitive complaints, and low scores on the Mini‐Mental State Exam (MMSE) were associated (P < 0.05) with frailty for both sexes. However, in the sex‐specific analysis, while smoking (OR = 3.66, 95% CI: 1.58–8.48) and a history of low adherence to ART (OR = 3.10, 95% CI: 1.33–7.23) were associated with frailty in men, depression (OR = 3.39, 95% CI: 1.36– 8.44) and the absence of functional dentition (OR = 3.77, 95% CI: 1.36– 10.43) were associated with frailty in women.ConclusionsThis study adds self‐reported cognitive complaints as a potential predictor of frailty in both sexes and supports the known deleterious effect of multimorbidity on frailty in adults living with HIV. Furthermore, it suggests that other possible predictors, such as depression, oral health status and adherence to ART, may be sex‐specific.

Ageing with HIV; a victory, a challenge and a call to action

“…Given the important hormonal changes associated with menopause, and pre-existing differences in skeletal muscle mass, there are likely important physiological and psychosocial differences in how men and women age. Tejo et al describe some of the differences between men and women with HIV, particularly that smoking is an important predictor of frailty in men, as is depression in women [9]. This article supports that more work is justified in this area to ensure that our knowledge of the drivers of frailty is robust and that care can truly be tailored to the individual.…”