Application of a Social Vulnerability Index and Its Associations with Physical Frailty and Disability in a Cross-sectional Study of Older Kenyan Women Living with and without HIV.
S Prabhu, B Oyaro, G Wanje, F M Aunon, N Gomez Juarez, B P Flaherty, W McCormick, M K Andrew, W Jaoko, R S McClelland, S M Graham
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引用次数: 0
Abstract
Background: Social vulnerability reflects deficits in social resources that may disproportionally impact older women with HIV (WWH) in Africa.
Objective: To examine the relationship between scores on an adapted Social Vulnerability Index (SVI) and measures of physical frailty and disability.
Design: Cross-sectional study.
Participants: 293 women (156 HIV-positive, 137 HIV-negative) aged >40 years in Mombasa, Kenya who were recruited from the Mombasa Cohort of women with a history of transactional sex and the general community.
Measurements: Assessments including an SVI adapted for the Kenyan context (SVI-Kenya), the Clinical Frailty Scale (CFS) and the World Health Organization Disability Assessment (WHODAS) were compared by HIV status. Linear regression was used to determine the relationship between SVI-Kenya score and both CFS and WHODAS, after adjustment for potential confounders. An exploratory analysis identified factors associated with SVI-Kenya score. An age-by-HIV-status interaction term was tested and retained if significant in unadjusted analyses.
Results: Mean SVI-Kenya score was 34.1 (SD, 12.9) and did not differ by HIV status (p=0.49). In adjusted analyses, each increment in SVI-Kenya score was associated with a 1.10-point higher WHODAS score (95%CI:0. 21, 1.99), but not with CFS. In exploratory analysis, factors associated with higher SVI-Kenya score included WHODAS score (adjusted beta=0.20; 95%CI: 0.05,0.35) and Mombasa Cohort recruitment (adjusted beta=5.91; 95%CI: 2.07,9.75). Being married, separated/divorced, or widowed predicted lower SVI-Kenya scores (by 5.52-9.09 points) compared to being single. Age did not predict SVI-Kenya score.
Conclusion: Social vulnerability as measured by the SVI-Kenya score was associated with greater disability but not physical frailty. Social vulnerability was also associated with prior sex work and never having married. Our findings suggest that social vulnerability is a distinct construct from physical frailty among older Kenyan women and not related to HIV status.
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).
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