FRAILTY AND PRE-FRAILTY IN A CONTEMPORARY COHORT OF HIV-INFECTED ADULTS
N.F. Önen, P. Patel, J. Baker, L. Conley, J.T. Brooks, T. Bush, K. Henry, J. Hammer, E.M. Kojic, E.T. Overton, for the SUN Study Investigators
J Frailty Aging 2014;3(3):158-165
Objectives: To determine the prevalence of pre-frailty among HIV-infected persons and associations with pre-frailty and frailty in this population. Design, Setting and Participants: From a contemporary, prospective observational cohort of HIV-infected persons (SUN Study), we determined, using a cross-sectional analytic study design, the proportions of non-frail, pre-frail, and frail persons by the respective presence of 0, 1-2, and ≥ 3 of 5 established frailty criteria: unintentional weight loss, exhaustion, physical-inactivity, weak-grip and slow-walk. We evaluated associations with pre-frailty/frailty using multivariate analysis. Results: Of 322 participants assessed (79% men, 58% white non-Hispanic, median age 47 years, 95% on combination antiretroviral therapy [cART], median CD4 + cell count 641 cells/mm3 and 93% HIV RNA < 400 copies/mL), 57% were non-frail, 38% pre-frail, and 5% frail. Age increased from non-frailty through frailty. Notably, however, half of pre-frail and frail participants were < 50 years, and of those, 42% and 100%, respectively, were long-term unemployed (versus 16% of non-frail counterparts). In multivariate analysis, pre-frail/frail participants were more likely to have Hepatitis C seropositivity (adjusted odds ratio [aOR] 3.24, 95% CI: 1.35-7.78), a history of AIDS-defining-illness (aOR 3.51, 95% CI: 1.82-6.76), greater depressive symptoms (aOR 1.16, 95% CI:1.09-1.23), higher D-dimer levels (aOR 2.94, 95% CI:1.10-7.87), and were less likely to be white non-Hispanic (aOR 0.35, 95% CI: 0.20-0.61). Conclusions: Pre-frailty and frailty are prevalent in the cART era and are associated with unemployment even among persons < 50 years. Pre-frailty appears to be an intermediate state in the spectrum from non-frailty through frailty and our characterization of pre-frailty/frailty suggests complex multifactorial associations.
N.F. Önen ; P. Patel ; J. Baker ; L. Conley ; J.T. Brooks ; T. Bush ; K. Henry ; J. Hammer ; E.M. Kojic ; E.T. Overton for the SUN Study Investigators (2014): FRAILTY AND PRE-FRAILTY IN A CONTEMPORARY COHORT OF HIV-INFECTED ADULTS. The Journal of Frailty and Aging (JFA). http://dx.doi.org/10.14283/jfa.2014.18