Department of Medicine, Albert Einstein College of Medicine, Bronx, NY.
Department of Statistics and Institute for Health, Health Care Policy and Aging Research, Rutgers University, Piscataway, NJ.
J Acquir Immune Defic Syndr. 2021 Jun 1;87(2):842-850. doi: 10.1097/QAI.0000000000002651.
Frailty may occur at younger ages among HIV+ populations. We evaluated associations of the frailty status with self-reported single and recurrent falls in the Women's Interagency HIV Study (WIHS).
The frailty status was defined using the Fried Frailty Phenotype (FFP) among 897 HIV+ and 392 HIV- women; median age 53 years. Women were classified as robust (FFP 0), prefrail (FFP 1-2), and frail (FFP 3-5). Stepwise logistic regression models adjusting for the HIV status and study site were fit to evaluate associations of the FFP with self-reported single (1 vs. 0) and recurrent falls (≥2 vs. 0) over the prior 12 months.
HIV+ women were less likely to be frail (9% vs. 14% vs. P = 0.009), but frequency of falls did not differ by the HIV status. In multivariate analyses, recurrent falls were more common among prefrail [adjusted odds ratio (AOR) 2.23, 95% confidence interval (CI): 1.40 to 3.57, P = 0.0008] and frail (AOR 3.61, 95% CI: 1.90 to 6.89, P < 0.0001) than robust women. Among HIV+ women, single (AOR 2.88, 95% CI: 1.16 to 7.20, P = 0.023) and recurrent falls (AOR 3.50, 95% CI: 1.24 to 9.88, P = 0.018) were more common among those who were frail; recurrent, but not single falls, were more common among prefrail than robust HIV+ women (AOR 2.00, 95% CI: 1.03 to 3.91, P = 0.042).
HIV+ women were less likely to be frail. Compared with robust women, prefrail and frail women with and without HIV were more likely to experience single or recurrent falls within a 12-month period. Additional studies are needed to develop interventions that decrease development of frailty and reduce risk of recurrent falls among HIV+ women.
在 HIV 阳性人群中,虚弱可能出现在更年轻的年龄。我们评估了虚弱状况与妇女艾滋病病毒研究机构间合作(WIHS)中自我报告的单次和反复跌倒之间的关联。
在 897 名 HIV 阳性和 392 名 HIV 阴性女性中,使用 Fried 虚弱表型(FFP)定义虚弱状况;中位年龄为 53 岁。女性被分为强壮(FFP 0)、虚弱前期(FFP 1-2)和虚弱(FFP 3-5)。调整 HIV 状态和研究地点的逐步逻辑回归模型用于评估 FFP 与过去 12 个月内自我报告的单次跌倒(1 次与 0 次)和反复跌倒(≥2 次与 0 次)的关联。
HIV 阳性女性发生虚弱的可能性较低(9%比 14%,P=0.009),但跌倒频率与 HIV 状态无关。在多变量分析中,虚弱前期(调整后的优势比 [AOR] 2.23,95%置信区间 [CI]:1.40 至 3.57,P=0.0008)和虚弱(AOR 3.61,95%CI:1.90 至 6.89,P<0.0001)女性比强壮女性更常见反复跌倒。在 HIV 阳性女性中,虚弱(AOR 2.88,95%CI:1.16 至 7.20,P=0.023)和反复跌倒(AOR 3.50,95%CI:1.24 至 9.88,P=0.018)更常见于虚弱者;与强壮的 HIV 阳性女性相比,虚弱前期女性更常见反复而非单次跌倒(AOR 2.00,95%CI:1.03 至 3.91,P=0.042)。
HIV 阳性女性虚弱的可能性较低。与强壮的女性相比,无论是否患有 HIV,虚弱前期和虚弱的女性在 12 个月内更有可能经历单次或反复跌倒。需要进一步研究以制定干预措施,减少 HIV 阳性女性虚弱的发展并降低反复跌倒的风险。