Date de publication

18 janvier 2020

Auteur(s)

Verheij, E., Kirk, GD et autres

Description

BACKGROUND:

Frailty is associated with mortality and morbidity in the general geriatric population, but less is known about its impact among the ageing but generally younger population with HIV (PWH).

METHODS:

The impact of frailty on all-cause mortality, during 6 years of follow-up and incident comorbidity, during 4 years of follow-up was assessed among 598 HIV-positive and 550 comparable HIV-negative participants of the AGEhIV Cohort Study, aged ≥45 years. Frailty encompasses 5 domains; weight loss, low physical activity, exhaustion, decreased grip strength, and slow gait speed. Presence of ≥3 denotes frailty, 1-2 prefrailty and 0 robust. Multivariable Cox and logistic regression models were used to assess the independent relationships of frailty with both outcomes, adjusting for HIV-infection and traditional risk factors.

RESULTS:

At baseline 7.5% (n=86) of participants were frail. During follow-up 38 participants died. Mortality rate was significantly higher among frail participants (frail 25.7/1,000person-years of follow-up (PYFU; 95%confidence interval[95%CI] 14.2-46.4); prefrail 7.2/1,000PYFU (95%CI,4.7-11.2); robust 2.3/1,000PYFU (95%CI,1.1-4.9)). In fully adjusted analyses, frailty remained strongly associated with death (HR4.6,1.7-12.5) and incident comorbidity (OR1.9,1.1-3.1). No interactions were observed between frailty- and HIV-status in all analyses.

CONCLUSIONS:

Frailty is a strong predictor of both mortality and incident comorbidity independent from other risk factors.