Handgrip Force Offers a Measure of Physical Function in Individuals Living With HIV/AIDS

Raso, Vagner; Shephard, Roy J.; Casseb, Jorge; Duarte, Alberto José da Silva; Greve, Júlia Maria D’Andréa

doi:10.1097/qai.0b013e31828c42bb

Cited by 15 publications

(19 citation statements)

References 21 publications

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“…Moreover, previous research limited to differences in grip strength by HIV serostatus has been cross sectional, focused on participants with lipodystrophy, or largely inconclusive[12, 13, 28], leaving the possibility of differences in the rate of strength decline undefined. The current study demonstrates a statistically significant difference in the trajectory of grip strength decline between men aging with HIV and demographically similar HIV− men.…”

Section: Discussionmentioning

confidence: 99%

Effect of HIV-infection and cumulative viral load on age-related decline in grip strength

Schrack

Jacobson

Althoff

et al. 2016

Aids

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Objective Grip strength predicts functional decline and death, and is regarded as a biomarker of biological aging. The primary objective of this manuscript was to assess differences in the rate of decline in grip strength in persons aging with and without HIV. Design Grip strength was assessed in 1,552 (716 HIV+ and 836 HIV−) men ≥ 50 years participating in the Multicenter AIDS Cohort Study between 2007 and 2014. Methods Grip strength decline was modeled longitudinally, adjusting for serostatus, demographics, comorbidities, and conditions. In HIV-specific models, coefficients were included for cumulative viral load and history of AIDS. Results Grip strength at age 50 averaged 37.9 kg and 38.2 kg for HIV+ and HIV− men, respectively (p = 0.70). In fully adjusted models, grip strength declined 0.33 kg/yr in HIV− men (p <0.001) and 0.42 kg/yr in HIV+ men (p = 0.01). In HIV-stratified models, higher cumulative viral load indicated greater strength decline (−0.884 kg for 3.1 – 4.0 log10 copies-years/mL and −1.077 kg for ≥ 4.1 log10 copies-years/mL) relative to men with consistently low viral load (≤ 3.0 log10 copies-years/mL). Adjusted Cox proportional hazard models revealed a 70% greater risk of clinically weak grip strength in HIV+ men (aHR 1.70; 95% CI, 1.22 – 2.40). Conclusions Grip strength decline is accelerated in HIV-infected men, which may contribute to decreased life expectancy and lower quality of life with aging. Greater cumulative viral load exposure appears to be an important driver of this decline and underscores the importance of early initiation of therapy.

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Section: Discussionmentioning

confidence: 99%

Effect of HIV-infection and cumulative viral load on age-related decline in grip strength

Schrack

Jacobson

Althoff

et al. 2016

Aids

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“…Our findings suggest that HIV disease severity may impact physical performance, with the greatest effect seen in patients with proximal CD4 + cell counts below 200 cells/μl. Limited data from prior studies also indicated that advanced HIV disease may be associated with functional limitations assessed by both subjective and objective methods [19,26,27], although contrasting data have been reported [28]. These data suggest that improved HIV control and earlier initiation of anti-retroviral therapy could positively impact physical performance.…”

Section: Discussionmentioning

confidence: 99%

“…The SPPB has been used extensively in research settings and can be integrated into clinical settings to identify patients at risk for adverse events [15,16]. Data on objective performance tests in HIV-infected populations have often been cross-sectional, without HIV-uninfected comparisons or linked to prospective assessment of associated clinical outcomes [17–19]. In the current study, we performed SPPB assessments in a large cohort of HIV-infected and epidemiologically similar HIV-uninfected persons over a 5-year-study period.…”

Section: Introductionmentioning

confidence: 99%

The relationship of physical performance with HIV disease and mortality

Greene

Covinsky

Astemborski

et al. 2014

Aids

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Objective To evaluate whether HIV infection was associated with reduced physical performance, and to examine if reduced physical performance predicted mortality in our aging cohort of HIV-infected and HIV-uninfected persons. Design Prospective, observational cohort of current and former injection drug users in the AIDS Linked to the IntraVenous Experience study in Baltimore, Maryland, USA. Methods The Short Physical Performance Battery (SPPB) was used as an objective measure of physical performance and measured semiannually along with behavioral and demographic data. Correlates of reduced physical performance (SPPB score ≤10) were identified and the relationship between reduced physical performance, HIV infection and mortality was analyzed by Cox regression. Results Among 12 270 person-visits contributed by 1627 participants, the median age was 51, 30.3% were HIV-infected and 32.6% had an SPPB score 10 or less. In multivariable models, HIV infection was independently associated with 30% increased odds of reduced physical performance [odds ratio 1.30; 95% confidence interval (CI):1.12–1.52]. Reduced physical performance predicted mortality in a dose-response manner and within all HIV disease strata. Whereas reduced physical performance alone (hazard ratio 2.52, 95% CI: 1.59–4.00) and HIV infection alone (hazard ratio 2.78, 95% CI: 1.70–4.54) increased mortality, HIV-infected participants with reduced physical performance had a six-fold increased mortality risk (hazard ratio 6.03, 95% CI: 3.80–10.0) compared with HIV-uninfected participants with higher physical performance. Conclusion HIV infection was independently associated with reduced physical performance. HIV and reduced physical performance have independent and joint effects on mortality. Physical performance measurement may be an important research and clinical tool to predict adverse outcomes among aging HIV-infected persons.

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“…The most commonly used field device is the handgrip dynamometer, and a recent analysis concluded that the handgrip force was well-correlated with overall muscular strength [31]. They are not well-suited to either the immediate or the longitudinal evaluation of patients with HIV/AIDS.…”

Section: Determinations Of Muscular Strengthmentioning

confidence: 99%

Measures of Physical Function in the Management of Individuals Living with HIV/AIDS

Raso

Shephard

2015

Health of HIV Infected People

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Handgrip Force Offers a Measure of Physical Function in Individuals Living With HIV/AIDS

Cited by 15 publications

References 21 publications

Effect of HIV-infection and cumulative viral load on age-related decline in grip strength

Effect of HIV-infection and cumulative viral load on age-related decline in grip strength

The relationship of physical performance with HIV disease and mortality

Measures of Physical Function in the Management of Individuals Living with HIV/AIDS

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