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感染艾滋病毒的老年男性退伍军人身体功能变化的种族差异。

Racial Differences in Change in Physical Functioning in Older Male Veterans with HIV.

作者信息

McKellar Mehri S, Kuchibhatla Maragatha N, Oursler Kris Ann K, Crystal Stephen, Akgün Kathleen M, Crothers Kristina, Gibert Cynthia L, Nieves-Lugo Karen, Womack Julie, Tate Janet P, Fillenbaum Gerda G

机构信息

Division of Infectious Diseases, Department of Medicine, Duke University, Durham, North Carolina.

Department of Biostatistics and Bioinformatics, Duke University, Durham, North Carolina.

出版信息

AIDS Res Hum Retroviruses. 2019 Nov/Dec;35(11-12):1034-1043. doi: 10.1089/AID.2018.0296. Epub 2019 Jun 18.

Abstract

Little is known about longitudinal change in physical functioning of older African American/Black and White HIV-infected persons. We examined up to 10 years of data on African American ( = 1,157) and White ( = 400) men with HIV infection and comparable HIV-negative men ( = 1,137 and 530, respectively), age 50-91 years from the Veterans Aging Cohort Study Survey sample. Physical functioning was assessed using the SF-12 (12-Item Short Form Health Survey) physical component summary (PCS) score. Mixed-effects models examined association of demographics, health conditions, health behaviors, and selected interactions with PCS score; HIV biomarkers were evaluated for HIV-infected persons. PCS scores were approximately one standard deviation below that of the general U.S. population of similar age. Across the four HIV/race groups, over time and through ages 65-75 years, PCS scores were maintained; differences were not clinically significant. PCS score was not associated with race or with interactions among age, race, and HIV status. CD4 and viral load counts of African American and White HIV-infected men were similar. Older age, low socioeconomic status, chronic health conditions and depression, lower body mass index, and smoking were associated with poorer PCS score in both groups. Exercising and, counterintuitively, being HIV infected were associated with better PCS score. Among these older African American and White male veterans, neither race nor HIV status was associated with PCS score, which remained relatively stable over time. Chronic disease, depression, and lack of exercise were associated with lower PCS score. To maintain independence in this population, attention should be paid to controlling chronic conditions, and emphasizing good health behaviors.

摘要

关于非裔美国/黑人及白人老年HIV感染者身体机能的纵向变化,我们所知甚少。我们从退伍军人老龄化队列研究调查样本中,研究了年龄在50 - 91岁的1157名非裔美国HIV感染者、400名白人HIV感染者以及与之匹配的1137名HIV阴性非裔美国男性和530名HIV阴性白人男性长达10年的数据。使用SF - 12(12项简短健康调查)身体成分汇总(PCS)得分来评估身体机能。混合效应模型研究了人口统计学、健康状况、健康行为以及选定的相互作用与PCS得分之间的关联;对HIV感染者评估了HIV生物标志物。PCS得分比美国同年龄的普通人群低约一个标准差。在这四个HIV/种族组中,随着时间推移以及在65 - 75岁年龄段,PCS得分保持稳定;差异无临床显著性。PCS得分与种族或年龄、种族和HIV状态之间的相互作用无关。非裔美国和白人HIV感染男性的CD4和病毒载量计数相似。在两组中,年龄较大、社会经济地位低、慢性健康状况和抑郁、较低的体重指数以及吸烟都与较差的PCS得分相关。锻炼以及与直觉相反的HIV感染与较好的PCS得分相关。在这些老年非裔美国和白人男性退伍军人中,种族和HIV状态均与PCS得分无关,PCS得分随时间保持相对稳定。慢性病、抑郁和缺乏锻炼与较低的PCS得分相关。为了维持该人群的独立性应注意控制慢性病并强调良好的健康行为。

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