Disability Among Middle-Aged and Older Persons With Human Immunodeficiency Virus Infection

Background. Older human immunodeficiency virus (HIV)-infected adults may experience higher rates of frailty and disability than the general population. Improved understanding of the prevalence, risk factors, and types of impairment can better inform providers and the healthcare system. Methods. HIV-...

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Bibliographic Details
Published in:Clinical infectious diseases 2017-07, Vol.65 (1), p.83-91
Main Authors: Johs, Nikolas A., Wu, Kunling, Tassiopoulos, Katherine, Koletar, Susan L., Kalayjian, Robert C., Ellis, Ronald J., Taiwo, Babafemi, Palella, Frank J., Erlandson, Kristine M.
Format: Article
Language:English
Subjects:
Acquired immune deficiency syndrome
Activities of Daily Living
Adult
Adults
Aged
AIDS
and Commentaries
Antiretroviral agents
Antiretroviral therapy
ARTICLES AND COMMENTARIES
Body weight loss
Clinical trials
Cognition
Comorbidity
Confidence intervals
Cross-Sectional Studies
Disability
Drugs
Exhaustion
Female
Frailty
Government programs
Grip strength
Health care
HIV
HIV Infections - epidemiology
Human immunodeficiency virus
Humans
Impairment
Infections
Male
Medical research
Middle age
Middle Aged
Older people
Physical activity
Regression analysis
Risk analysis
Risk factors
Smoking
Viruses
Weight loss measurement
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Summary:Background. Older human immunodeficiency virus (HIV)-infected adults may experience higher rates of frailty and disability than the general population. Improved understanding of the prevalence, risk factors, and types of impairment can better inform providers and the healthcare system. Methods. HIV-infected participants within the AIDS Clinical Trials Group A5322 HAILO study self-reported disability by the Lawton-Brody Instrumental Activities of Daily Living (IADL) Questionnaire. Frailty was measured by 4-m walk time, grip strength, self-reported weight loss, exhaustion, and low activity. Logistic regression models identified characteristics associated with any IADL impairment. Agreement between IADL impairment and frailty was assessed using the weighted kappa statistic. Results. Of 1015 participants, the median age was 51 years, 15% were aged ≥60 years, 19% were female, 29% black, and 20% Hispanic. At least 1 IADL impairment was reported in 18% of participants, most commonly with housekeeping (48%) and transportation (36%) and least commonly with medication management (5%). In multivariable models, greater disability was significantly associated with neurocognitive impairment, lower education, Medicare/Medicaid insurance (vs private/other coverage), smoking, and low physical activity. Although a greater proportion of frail participants had IADL impairment (52%) compared to non-frail (11%) persons, agreement was poor (weighted kappa
ISSN:1058-4838
1537-6591
DOI:10.1093/cid/cix253