Smit E, Wanke C, Dong K, Grotheer A, Hansen S, Skinner S, Tang A M
School of Biological and Population Health Sciences, Oregon State University, Corvallis, OR, USA.
Department of Public Health and Community Medicine, Tufts School of Medicine, Boston, MA, USA.
J Frailty Aging. 2015;4(4):191-7. doi: 10.14283/jfa.2015.50.
Nutritional status and food insecurity are associated with frailty in the general U.S. population, yet little is known about this in the aging population of people living with HIV (PLWH).
Given the potential importance of nutrition and the amenability to intervention, we examined the association between nutritional status, food insecurity, and frailty in PLWH.
Cross sectional study.
Boston, Massachusetts, U.S.A.
50 PLWH, age ≥45 years, recruited from a cohort study examining risk factors for cardiovascular disease.
Frailty, duration of HIV, use of antiretroviral therapy, disease history, food insecurity, physical function, and physical activity were assessed by questionnaire. Dietary intake was assessed using 3-day food records. Blood was drawn for CD4+ cell count, hemoglobin, hematocrit, and lipid levels. Physical measurements included height, weight, and skinfold thickness.
The prevalence of frailty was 16% (n=8), 44% were pre-frail (n=22) and 40% were not frail (n=20). The number of reported difficulties with 20 activities of daily living was highest in frail (mean 10.4±3.9 SD), followed by pre-frail (6.5±4.6), and lowest in not frail participants (2.0±2.3). Seven (88%) of the frail PLWH lost weight with an average weight loss of 22.9 pounds; 6 (75%) reported unintentional weight loss, and all 6 of these met the frailty criteria for weight loss of 10 or more pounds. Nine (45%) of the not frail PLWH reported losing weight with an average weight loss of 6.2 pounds; 5 (23%) reported unintentional weight loss of <10 pounds. Frail PLWH were more likely to report being food insecure than not frail PLWH (63% vs. 10%, p=0.02), and tended to have lower energy intake than not frail PLWH.
Research is needed on targeted interventions to improve food security and activities of daily living in PLWH for both the prevention and improvement of frailty.
在美国普通人群中，营养状况和粮食不安全与身体虚弱有关，但在感染艾滋病毒的老年人群（PLWH）中，对此了解甚少。
鉴于营养的潜在重要性以及干预的可行性，我们研究了PLWH中营养状况、粮食不安全与身体虚弱之间的关联。
横断面研究。
美国马萨诸塞州波士顿。
从一项研究心血管疾病危险因素的队列研究中招募了50名年龄≥45岁的PLWH。
通过问卷调查评估身体虚弱、艾滋病毒感染持续时间、抗逆转录病毒疗法的使用、疾病史、粮食不安全、身体功能和身体活动。使用3天食物记录评估饮食摄入量。采集血液检测CD4 +细胞计数、血红蛋白、血细胞比容和血脂水平。身体测量包括身高、体重和皮褶厚度。
身体虚弱的患病率为16%（n = 8），44%为虚弱前期（n = 22），40%不虚弱（n = 20）。在20项日常生活活动中，报告有困难的数量在虚弱者中最高（平均10.4±3.9标准差），其次是虚弱前期（6.5±4.6），在非虚弱参与者中最低（2.0±2.3）。7名（88%）虚弱的PLWH体重减轻，平均体重减轻22.9磅；6名（75%）报告有非故意体重减轻，且这6名均符合体重减轻10磅或更多的虚弱标准。9名（45%）非虚弱的PLWH报告体重减轻，平均体重减轻6.2磅；5名（23%）报告非故意体重减轻<10磅。与非虚弱的PLWH相比，虚弱的PLWH更有可能报告粮食不安全（63%对10%，p = 0.02），并且能量摄入量往往低于非虚弱的PLWH。
需要开展针对性干预措施的研究，以改善PLWH的粮食安全和日常生活活动，预防和改善身体虚弱。
