Physical Functioning Among Patients Aging With Human Immunodeficiency Virus (HIV) Versus HIV Uninfected: Feasibility of Using the Short Physical Performance Battery in Clinical Care of People Living With HIV Aged 50 or Older

Crane, Heidi M.; Miller, Michael E.; Pierce, J. Thomas; Willig, Amanda L.; Case, Michael Lloyd; Wilkin, Aimee M.; Brown, Sharon; Asirot, Mary Grace; Fredericksen, Rob J.; Saag, Michael S.; Landay, Alan; High, Kevin P.

doi:10.1093/ofid/ofz038

Cited by 16 publications

(21 citation statements)

References 25 publications

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Section: Discussionmentioning

confidence: 94%

“…Recent publications in older PLHIV from western countries reported similar results for the SPPB performance. In PLHIV aged 50 years or above living in the United States, it was reported a similar mean score (10.3 to 10.7) [ 21 , 22 ], a score similar to nearly 20-year older controls [ 21 ]. Another study in female PLHIV reported that 20% of them performed poorly with a median score of 11, but they discussed the possibility of a ceiling effect because of the participant’s age in their sample (i.e.…”

Section: Discussionmentioning

confidence: 99%

“…The most altered component of the SPPB test was the 5STS as observed in middle-aged PLHIV in western countries [ 9 , 10 ] and in older PLHIV [ 21 , 22 ]. PLHIV needed more time to complete the test than controls [ 22 ] but less than the nearly 20-year older controls [ 21 ]. As recommended in an editorial in AIDS [ 30 ], the 5STS might be the most appropriate test to evaluate physical function in the standard care of PLHIV.…”

Section: Discussionmentioning

confidence: 99%

“…Functional impairment is associated with low bone and muscle mass among persons aging with HIV-infection [25]. In PLHIV but also in the general population, low SPPB performance has already been associated with poorer outcomes such as having additional comorbidities, subsequent disability, falls, higher mortality, and hospitalization rates [15,21,24,[26][27][28][29], highlighting the importance of the screening of this impairment.…”

Section: Discussionmentioning

confidence: 99%

“…For each test and the “physical function impairment” variable, the prevalence of low performance was reported. As SPPB has been used for >20 years to measure physical performance in older adults [ 15 ] and as it is a complete brief battery feasible to implement in HIV clinical care [ 21 ], the further analyses focused on this test. Associations between low SPPB performance and both other tests performance and daily physical activities were evaluated with Chi-2 tests, except for grip strength for which the Student T-test was performed in each gender group separately.…”

Section: Methodsmentioning

confidence: 99%

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Prevalence and factors associated with physical function limitation in older West African people living with HIV

et al. 2020

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Although physical function decline is common with aging, the burden of this impairment remains underestimated in patients living with HIV (PLHIV), particularly in the older people receiving antiretroviral treatment (ART) and living in sub-Saharan Africa (SSA). PLHIV aged ≥50 years old and on ART since ≥6 months were included (N = 333) from three clinics (two in Côte d’Ivoire, one in Senegal) participating in the International epidemiological Databases to Evaluate AIDS (IeDEA) West Africa collaboration. Physical function was measured using the Short Physical Performance Battery (SPPB), the unipodal balance test and self-reported questionnaires. Grip strength was also assessed. Logistic regression was used to identify the factors associated with SPPB performance specifically. Median age was 57 (54–61) years, 57.7% were female and 82.7% had an undetectable viral load. The mean SPPB score was 10.2 ±1.8. Almost 30% had low SPPB performance with the 5-sit-to-stand test being the most altered subtest (64%). PLHIV with low SPPB performance also had significantly low performance on the unipodal balance test (54.2%, p = 0.001) and low mean grip strength (but only in men (p = 0.005)). They also showed some difficulties in daily life activities (climbing stairs, walking one block, both p<0.0001). Age ≥60 years (adjusted OR (aOR) = 3.4; CI95% = 1.9–5.9,), being a female (aOR = 2.1; CI95% = 1.1–4.1), having an abdominal obesity (aOR = 2.1; CI95% = 1.2–4.0), a longer duration of HIV infection (aOR = 2.9; CI95% = 1.5–5.7), old Nucleoside reverse transcriptase inhibitors (NRTIs) (i.e., AZT: zidovudine, ddI: didanosine, DDC: zalcitabine, D4T: stavudine) in current ART (aOR = 2.0 CI95% = 1.1–3.7) were associated with low SPPB performance. As in western countries, physical function limitation is now part of the burden of HIV disease complications of older PLHIV living in West Africa, putting this population at risk for disability. How to screen those impairments and integrate their management in the standards of care should be investigated, and specific research on developing adapted daily physical activity program might be conducted.

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