Measuring Frailty in HIV-infected Individuals. Identification of Frail Patients is the First Step to Amelioration and Reversal of Frailty

Rees, H; Ianas, Voichita; McCracken, Patricia; Smith, Shannon; Georgescu, Anca Meda; Zangeneh, Tirdad T.; Mohler, Jane; Klotz, Stephen A.

doi:10.3791/50537-v

Cited by 2 publications

(2 citation statements)

References 8 publications

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“…Early diagnosis and modern antiretroviral therapy has transformed care for people with HIV, who now are an aging population. As age-associated falls and frailty become more prevalent, greater emphasis on reducing the modifiable risk factors for these events is needed [14,[37][38][39].…”

Section: Discussionmentioning

confidence: 99%

Anticholinergic medications associated with falls and frailty in people with HIV

Doctor,

Winston,

Vera

et al. 2023

HIV Medicine

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BackgroundAnticholinergic medications (ACMs) are associated with poorer age‐related outcomes, including falls and frailty. We investigate associations between ACM use and recurrent falls and frailty among older (aged ≥50 years) people with HIV in the POPPY study.MethodsAnticholinergic potential of co‐medications at study entry was coded using the anticholinergic burden score, anticholinergic risk score, and Scottish Intercollegiate Guidelines Network score; drugs scoring ≥1 on any scale were defined as ACM. Associations with recurrent falls (two or more falls in the previous 28 days) and frailty (modified Fried's) were assessed using logistic regression adjusting for (1) possible demographic/lifestyle confounders and (2) clinical factors and depressive symptoms (Patient Health Questionnaire‐9).ResultsACM use was reported by 193 (28%) of 699 participants, with 64 (9%) receiving two or more ACM; commonly prescribed ACMs were codeine (12%), citalopram (12%), loperamide (9%), and amitriptyline (7%). Falls were reported in 63/673 (9%), and 126/609 (21%) met the frailty criteria. Both recurrent falls and frailty were more common in ACM users than in non‐users (recurrent falls: 17% in users vs. 6% in non‐users, p < 0.001; frailty: 32% vs. 17%, respectively, p < 0.001). Use of two or more ACMs was associated with increased odds of falls after adjustment for demographic/lifestyle factors (odds ratio [OR] 4.53; 95% confidence interval [CI] 2.06–9.98) and for clinical factors (OR 3.58; 95% CI 1.37–9.38). Similar albeit weaker associations were seen with frailty (OR 2.26; 95% CI 1.09–4.70 and OR 2.12; 95% CI 0.89–5.0, respectively).ConclusionsACM are commonly prescribed for people living with HIV, and evidence exists for an association with recurrent falls and frailty. Clinicians should be alert to this and reduce ACM exposure where possible.

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Section: Discussionmentioning

confidence: 99%

Anticholinergic medications associated with falls and frailty in people with HIV

Doctor,

Winston,

Vera

et al. 2023

HIV Medicine

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“…The P ‐value of the slope was not significant, which meant the frailty of those residents remained stable during the follow‐up period. As frailty is reversible, particularly during its early stage, 32 effective interventions should be implemented for those residents to reverse frailty. Moreover, fairly consistent with the US nursing home study, 14 this study revealed a non‐frailty trajectory.…”

Section: Discussionmentioning

confidence: 99%

Chewing difficulty and frailty trajectories in Chinese nursing home residents: A prospective cohort study

Wang,

Luo

et al. 2023

Geriatrics Gerontology Int

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AimTo investigate frailty trajectories in nursing home residents, and to test whether chewing difficulty was a significant factor associated with frailty trajectories.MethodsThis is a 1‐year prospective cohort study. Data were collected from 27 nursing home residents in China at baseline, 6 months, and 12 months. Latent class growth modeling was used to identify frailty trajectories. Multilevel multinomial logistic regression was used to test the relative risk ratios (RRRs) with 95% confidence intervals (CIs) of the chewing difficulty assessed at baseline on frailty trajectories.ResultsIn total, 269 nursing home residents were included in the analysis. Three frailty trajectories identified were non‐frailty trajectory (n = 181, 67.3%), stable frailty trajectory (n = 52, 19.3%), and progressive frailty trajectory (n = 36, 13.4%). Chewing difficulty was found among 138 (51.3%) nursing home residents. With the non‐frailty trajectory group as the reference, residents with chewing difficulty were more likely to demonstrate stable frailty trajectory (RRR = 2.55, 95% CI [1.28–5.11]) or progressive frailty trajectory (RRR = 3.46, 95% CI [1.47–8.15]).ConclusionsChanges in the frailty of nursing home residents are heterogeneous and chewing difficulty should be assessed and addressed on a routine basis in nursing homes to prevent the deterioration of frailty or reverse it. Geriatr Gerontol Int 2023; ••: ••–••.

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Measuring Frailty in HIV-infected Individuals. Identification of Frail Patients is the First Step to Amelioration and Reversal of Frailty

Cited by 2 publications

References 8 publications

Anticholinergic medications associated with falls and frailty in people with HIV

Anticholinergic medications associated with falls and frailty in people with HIV

Chewing difficulty and frailty trajectories in Chinese nursing home residents: A prospective cohort study

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