Systematic Review of Prevalence and Predictors of Frailty in Individuals with Human Immunodeficiency Virus

Levett, Tom; Cresswell, Fiona V; Malik, Muzaffar; Fisher, Martin; Wright, Juliet

doi:10.1111/jgs.14101

Cited by 77 publications

(84 citation statements)

References 35 publications

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“…As a recent review suggested, these findings suggest that the microbiota and microbiome may influence the development or changes of the host immune system, contribute to inflamm‐aging, lead to certain chronic health conditions, and affect the aging process . Some studies suggest that certain viruses may be a risk factor for or predictor of frailty in older adults . Conversely, frailty and functional status have not only been associated with greater risk of infection, but also affect the outcomes of older adults with serious infections, especially respiratory infections …”

Section: General Problem Of Geriatric Infectious Diseasementioning

confidence: 99%

“…3 Some studies suggest that certain viruses may be a risk factor for or predictor of frailty in older adults. 5,6 Conversely, frailty and functional status have not only been associated with greater risk of infection, but also affect the outcomes of older adults with serious infections, especially respiratory infections. 7…”

Section: General Problem Of Geriatric Infectious Disease Epidemiologymentioning

confidence: 99%

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Geriatric Infectious Diseases: Current Concepts on Diagnosis and Management

Yoshikawa

Norman

2017

J American Geriatrics Society

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New information on infectious diseases in older adults has become available in the past 20 years. In this review, in-depth discussions on the general problem of geriatric infectious diseases (epidemiology, pathogenesis, age-related host defenses, clinical manifestations, diagnostic approach); diagnosis and management of bacterial pneumonia, urinary tract infection, and Clostridium difficile infection; and the unique challenges of diagnosing and managing infections in a long-term care setting are presented.

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Section: General Problem Of Geriatric Infectious Diseasementioning

confidence: 99%

Section: General Problem Of Geriatric Infectious Disease Epidemiologymentioning

confidence: 99%

Geriatric Infectious Diseases: Current Concepts on Diagnosis and Management

Yoshikawa

Norman

2017

J American Geriatrics Society

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“…Frailty is a phenotype that accounts for some of this variability; within each stratum of disability, frailty predicts survival [1,2]. Adults living with HIV exhibit frailty more frequently than HIV-negative individuals of similar age, but whether this increase is a consequence of HIV itself or of its comorbidities is debated [3,4]. Some also question the validity of frailty measurement tools in populations with mean ages under 50 [3,4].…”

Section: Introductionmentioning

confidence: 99%

“…Adults living with HIV exhibit frailty more frequently than HIV-negative individuals of similar age, but whether this increase is a consequence of HIV itself or of its comorbidities is debated [3,4]. Some also question the validity of frailty measurement tools in populations with mean ages under 50 [3,4]. As combination antiretroviral therapy (cART)-era HIV populations enter decades for which common frailty measures were designed, determinants of frailty will be important to identify in order to optimize clinical management.…”

Section: Introductionmentioning

confidence: 99%

Frailty in medically complex individuals with chronic HIV

Morgello

Sherman

Ellis

et al. 2019

Aids

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Sueiras i , for the NNTC Objectives: Multimorbidity and frailty are consequences of aging with HIV, yet not everyone with medical disease is frail. Our objective was to identify factors associated with frailty in a multimorbid HIV-infected cohort. Design: Analysis of a prospective, observational, longitudinal cohort. Methods: Three hundred and thirty-two participants in the medically advanced NNTC were categorized as frail, prefrail, or robust with the Fried Frailty Index. A series of logistic regression analyses (first univariate, then multivariable) were conducted to determine whether medical comorbidities, immunologic and virologic parameters, and/or neuropsychiatric variables predicted increased odds of frailty. Results: The mean number of medical comorbidities per participant was 2.7, mean CD4 þ T-cell count was 530 cells/ml, and 77% had undetectable HIV RNA in blood. Twenty-two percent were frail, 55% prefrail, and 23% robust. Significant predictors of frailty in multivariable analysis were cognitive diagnosis rendered by Frascati criteria, depressive symptoms, diabetes mellitus, chronic obstructive pulmonary disease (COPD), and sex. Men were less likely to be frail than women. Higher odds of frailty were seen with: symptomatic, but not asymptomatic, cognitive impairment (compared with cognitive normals); more depressive symptoms; diabetes mellitus; and COPD. Conclusion: Neuropsychiatric illness increased odds of being frail on a predominantly physical/motoric measure, but only when symptomatic. Lack of association with asymptomatic impairment may reflect the importance of functional limitation to frailty, or possibly a unique resilience phenotype. Understanding why sex and symptomatic neuropsychiatric illness are associated with frailty will be important in managing HIVassociated morbidity in aging populations.

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“…Baseline frailty status predicted adverse patient outcomes such as falls, hospitalisation and death 4. This model is the most frequently used tool in frailty research,6 especially in the context of HIV 7. However, it has been challenged as being less practical to apply in clinical settings and criticised for its unidimensional nature that focuses mainly on muscle strength and function, neglecting psychological and social factors which are known to impact on frailty 3 8…”

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confidence: 99%