Citation

Tassiopoulos K, Abdo M, Wu K, Koletar SL, Palella FJ, Kalayjian R, Taiwo B, Erlandson KM. AIDS 2019; ePub(ePub): ePub.

Affiliation

aHarvard T.H. Chan School of Public Health, Department of Epidemiology, Boston, MA, U.S. bHarvard T.H. Chan School of Public Health, Center for Biostatistics in AIDS Research, Boston, MA, U.S. cOhio State University, Department of Internal Medicine; Columbus, OH, U.S. dNorthwestern University Feinberg School of Medicine, Department of Medicine; Chicago, IL, U.S. eMetroHealth and Louis Stokes Cleveland Veterans Administration Medical Center, Department of Medicine; Cleveland, OH, U.S. fUniversity of Colorado-Anschutz Medical Campus, Department of Medicine; Aurora, CO, U.S.

Copyright

(Copyright © 2019, Lippincott Williams and Wilkins)

DOI

10.1097/QAD.0000000000001613

PMID

28806197

Abstract

OBJECTIVE: Both frailty and falls occur at earlier than expected ages among HIV-infected individuals, but the contribution of frailty to fall risk in this population is not well understood. We examined this association among participants enrolled in AIDS Clinical Trials Group (ACTG) A5322.

DESIGN: A prospective, multi-center cohort study of HIV-infected men and women ≥40 years.

METHODS: Frailty assessment included a 4-meter walk, grip strength, and self-reported weight loss, exhaustion, and low physical activity. Multinomial logistic regression assessed the association between baseline frailty, grip, and 4-meter walk and single and recurrent (2+) falls over the next 12 months; logistic regression assessed effect modification by several factors on association between frailty and any (1+) falls.

RESULTS: Of 967 individuals, 6% were frail, 39% pre-frail, and 55% non-frail. Eighteen percent had ≥1 fall, and 7% had recurrent falls. In multivariable models, recurrent falls were more likely among frail (OR = 17.3; 95% CI = 7.03-42.6) and pre-frail (OR = 3.80; 95% CI = 1.87-7.72) than non-frail individuals. Significant associations were also seen with recurrent falls and slow walk and weak grip. The association between frailty and any falls was substantially stronger among individuals with peripheral neuropathy.

CONCLUSIONS: Aging HIV-infected pre-frail and frail individuals are at significantly increased risk of falls. Incorporation of frailty assessments or simple evaluations of walk speed or grip strength in clinical care may help identify individuals at greatest risk for falls. Peripheral neuropathy further increases fall risk among frail persons, defining a potential target population for closer fall surveillance, prevention, and treatment.

Language: en