HIV 感染和年龄增长对日常功能的协同影响。
Synergistic effects of HIV infection and older age on daily functioning.
机构信息
Department of Psychiatry, University of California, San Diego, CA 92103, USA.
出版信息
J Acquir Immune Defic Syndr. 2012 Nov 1;61(3):341-8. doi: 10.1097/QAI.0b013e31826bfc53.
OBJECTIVE
To determine whether HIV infection and aging act synergistically to disrupt everyday functioning.
DESIGN
Cross-sectional factorial study of everyday functioning in the context of HIV serostatus and age (≤40 years vs. ≥50 years).
METHODS
One hundred three HIV+ and 87 HIV- participants were administered several measures of everyday functioning, including self-report indices of health-related quality of life (HRQoL) and instrumental and basic activities of daily living (IADLs and BADLs), and objective measures of functioning, including employment and Karnofsky Performance Scale ratings.
RESULTS
Significant interaction effects of HIV and aging were observed for IADL and BADL declines, and for Karnofsky Performance Scale ratings (Ps < 0.05), independent of potentially confounding factors. Follow-up contrasts revealed significantly worse functioning in the older HIV+ group for most functional outcome measures relative to the other study groups (Ps < 0.05). A significant interaction effect was also observed on the emotional functioning HRQoL subscale, and additive effects of both age and HIV were observed for the physical functioning and general health perceptions HRQoL subscales (Ps < 0.05). Significant predictors of poorer functioning in the older HIV+ group included current major depressive disorder for all outcomes, and comorbid medical conditions, lower estimated premorbid functioning, neurocognitive impairment, and nadir CD4 count for selected outcomes.
CONCLUSION
Findings suggest that older age may exacerbate the adverse effects of HIV on daily functioning, which highlights the importance of evaluating and monitoring the functional status of older HIV-infected adults. Early detection of functional difficulties could facilitate delivery of compensatory strategies (eg, cognitive remediation) or assistive services.
目的
确定 HIV 感染和衰老是否协同作用，破坏日常功能。
设计
在 HIV 血清状态和年龄（≤40 岁与≥50 岁）背景下，对日常功能进行的横断面析因研究。
方法
103 名 HIV+和 87 名 HIV-参与者接受了几项日常功能评估，包括健康相关生活质量（HRQoL）的自我报告指标以及工具性和基础性日常生活活动（IADLs 和 BADLs），以及功能的客观指标，包括就业和 Karnofsky 表现量表评分。
结果
观察到 HIV 和衰老的显著交互作用，对 IADL 和 BADL 的下降以及 Karnofsky 表现量表评分有影响（P < 0.05），独立于潜在的混杂因素。随访对比显示，与其他研究组相比，年龄较大的 HIV+组在大多数功能结果测量上的功能更差（P < 0.05）。在情绪功能 HRQoL 亚量表上也观察到显著的交互作用，并且在身体功能和总体健康感知 HRQoL 亚量表上观察到年龄和 HIV 的累加效应（P < 0.05）。年龄较大的 HIV+组功能更差的显著预测因素包括所有结果的当前重度抑郁障碍，以及合并的医疗状况、较低的预计发病前功能、认知障碍和选定结果的最低 CD4 计数。
结论
研究结果表明，年龄较大可能会加剧 HIV 对日常功能的不利影响，这凸显了评估和监测老年 HIV 感染者的功能状态的重要性。早期发现功能障碍可以促进实施补偿策略（例如认知矫正）或提供辅助服务。
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