Frailty-Related Factors among Women Living with and without HIV Aged 40 Years and Older. The Women's Interagency HIV Study.

IF 3.3 Q2 GERIATRICS & GERONTOLOGY Journal of Frailty & Aging Pub Date : 2024-01-01 DOI:10.14283/jfa.2023.41

D R Gustafson, Q Shi, M Thurn, S Holman, M H Kuniholm, M Fischl, M Floris-Moore, S Gange, D Konkle-Parker, M Plankey, J C Price, R D Ross, A Rubtsova, A Sharma, D R Hoover

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Abstract

Background: Frailty is a clinical, geriatric syndrome linked to disability and mortality; and may be associated with a variety of factors among underrepresented and underserved women living with HIV (WLWH) and without HIV (WLWOH) transitioning through the adult life course.

Objectives: Determine whether a published set of factors associated cross-sectionally with frailty in WLWH and similar WLWOH at average age 39 years in 2005/2006 were associated with frailty in 2018/2019 among women who initiated frailty assessments at age ≥40 years, or whether a new set of factors were associated with frailty.

Design: Cross-sectional analyses within a longitudinal cohort study.

Setting: The multi-center Women's Interagency HIV Study (WIHS).

Participants: 1285 participants (951 WLWH, 334 WLWOH), median age 53 years (interquartile range 47-58 years).

Measurements: The Fried Frailty Phenotype (FFP) in association with 23 factors representing HIV serostatus, other infections, sociodemographic factors, health behaviors, and chronic diseases.

Results: Frailty prevalence was 11.1% in 2018/2019 (12.6% among WLWOH, 9.6% among WLWH, p=0.121). The published 2005/2006 final multivariable stepwise regression model contained 9 predictors of frailty. When refit to women in 2018/2019, only age ≥50 years and annual income ≤$12,000 were independently positively associated with frailty; other significant 2005/2006 factors, HIV serostatus, CD4+ count <500 cells/mL among WLWH, smoking, drinking, FIB-4 and eGFR, were not. A newly-derived stepwise model considering all 23 predictors measured in 2018/2019, showed independent positive associations between frailty and age ≥50 years, annual income ≤$12,000, obesity (body mass index (BMI) ≥30kg/m2), and history of tuberculosis and cancer.

Conclusion: Different chronic and infectious disease factors were associated with frailty among WLWH and WLWOH over the adult life course. Understanding factors associated with frailty by adult life stage, allows identification and implementation of novel, temporal interventions to alleviate frailty-associated outcomes and enhance quality of life among WLWH and WLWOH.

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40 岁及以上女性艾滋病病毒感染者和非艾滋病病毒感染者的虚弱相关因素。妇女机构间艾滋病研究。

背景：虚弱是一种与残疾和死亡率相关的临床老年综合征；在感染艾滋病毒（WLWH）和未感染艾滋病毒（WLWOH）的人数不足和服务欠缺的成年女性中，虚弱可能与多种因素有关：在年龄≥40岁开始进行虚弱评估的女性中，确定已公布的一组与2005/2006年平均年龄为39岁的WLWH和类似WLWOH的虚弱相关的横断面因素是否与2018/2019年的虚弱相关，或者一组新的因素是否与虚弱相关：纵向队列研究中的横断面分析：多中心妇女艾滋病机构间研究（WIHS）：1285 名参与者（951 名 WLWH，334 名 WLWOH），中位年龄 53 岁（四分位数范围 47-58 岁）：弗里德虚弱表型（FFP）与代表 HIV 血清状态、其他感染、社会人口因素、健康行为和慢性疾病的 23 个因素相关联：2018/2019年的虚弱发生率为11.1%（WLWOH为12.6%，WLWH为9.6%，P=0.121）。已公布的 2005/2006 年最终多变量逐步回归模型包含 9 个虚弱预测因子。当重新调整为 2018/2019 年的女性时，只有年龄≥50 岁和年收入≤12,000 美元与虚弱有独立的正相关关系；其他重要的 2005/2006 年因素、HIV 血清状态、CD4+ 细胞计数结论：年龄≥50 岁和年收入≤12,000 美元与虚弱有独立的正相关关系：在 WLWH 和 WLWOH 的成年生活过程中，不同的慢性病和传染病因素与体弱有关。通过了解不同成年阶段与虚弱相关的因素，可以确定并实施新颖的临时干预措施，以减轻与虚弱相关的结果，提高 WLWH 和 WLWOH 的生活质量。

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来源期刊

Journal of Frailty & Aging GERIATRICS & GERONTOLOGY-

CiteScore

5.90

自引率

7.70%

发文量

期刊介绍： The Journal of Frailty & Aging is a peer-reviewed international journal aimed at presenting articles that are related to research in the area of aging and age-related (sub)clinical conditions. In particular, the journal publishes high-quality papers describing and discussing social, biological, and clinical features underlying the onset and development of frailty in older persons. The Journal of Frailty & Aging is composed by five different sections: - Biology of frailty and aging In this section, the journal presents reports from preclinical studies and experiences focused at identifying, describing, and understanding the subclinical pathophysiological mechanisms at the basis of frailty and aging. - Physical frailty and age-related body composition modifications Studies exploring the physical and functional components of frailty are contained in this section. Moreover, since body composition plays a major role in determining physical frailty and, at the same time, represents the most evident feature of the aging process, special attention is given to studies focused on sarcopenia and obesity at older age. - Neurosciences of frailty and aging The section presents results from studies exploring the cognitive and neurological aspects of frailty and age-related conditions. In particular, papers on neurodegenerative conditions of advanced age are welcomed. - Frailty and aging in clinical practice and public health This journal’s section is devoted at presenting studies on clinical issues of frailty and age-related conditions. This multidisciplinary section particularly welcomes reports from clinicians coming from different backgrounds and specialties dealing with the heterogeneous clinical manifestations of advanced age. Moreover, this part of the journal also contains reports on frailty- and age-related social and public health issues. - Clinical trials and therapeutics This final section contains all the manuscripts presenting data on (pharmacological and non-pharmacological) interventions aimed at preventing, delaying, or treating frailty and age-related conditions.The Journal of Frailty & Aging is a quarterly publication of original papers, review articles, case reports, controversies, letters to the Editor, and book reviews. Manuscripts will be evaluated by the editorial staff and, if suitable, by expert reviewers assigned by the editors. The journal particularly welcomes papers by researchers from different backgrounds and specialities who may want to share their views and experiences on the common themes of frailty and aging.The abstracting and indexing of the Journal of Frailty & Aging is covered by MEDLINE (approval by the National Library of Medicine in February 2016).