Division of Geriatrics and Palliative Medicine, Weill Cornell Medicine, New York, US.
Division of Infectious Diseases, Weill Cornell Medicine, New York, US.
J Gerontol B Psychol Sci Soc Sci. 2022 Jan 12;77(1):50-60. doi: 10.1093/geronb/gbab027.
People living with human immunodeficiency virus (PLWH) treated with antiretrovirals have life spans similar to their HIV-negative peers. Yet, they experience elevated inflammation-related multimorbidity. Drawing on biopsychosocial determinants of health may inform interventions, but these links are understudied in older PLWH. We investigated cross-sectional relationships between psychosocial factors (mood, loneliness, and stigma), inflammatory markers, and age-related health outcomes among 143 PLWH aged 54-78 years.
Participants provided blood samples for serum cytokine and C-reactive protein (CRP) analyses, completed surveys assessing psychosocial factors and health, and completed frailty assessments. Regression models tested relationships between key psychosocial-, inflammation, and age-related health variables, adjusting for relevant sociodemographic and clinical factors.
Participants with more depressive symptoms had higher composite cytokine levels than those with fewer depressive symptoms (β = 0.22, t(126) = 2.71, p = .008). Those with higher cytokine levels were more likely to be prefrail or frail (adjusted odds ratio = 1.72, 95% confidence interval = 1.01-2.93) and reported worse physical function (β = -0.23, t(129) = -2.64, p = .009) and more cognitive complaints (β = -0.20, t(129) = -2.16, p = .03) than those with lower cytokine levels. CRP was not significantly related to these outcomes; 6-month fall history was not significantly related to inflammatory markers.
Novel approaches are needed to manage comorbidities and maximize quality of life among older PLWH. Illustrating key expected biopsychosocial links, our findings highlight several factors (e.g., depressive symptoms, poorer physical function) that may share bidirectional relationships with chronic inflammation, a key factor driving morbidity. These links may be leveraged to modify factors that drive excessive health risk among older PLWH.
接受抗逆转录病毒治疗的艾滋病毒感染者（PLWH）的寿命与 HIV 阴性同龄人相似。然而，他们经历着更高的与炎症相关的多种合并症。借鉴健康的心理社会决定因素可能为干预措施提供信息，但这些关联在老年 PLWH 中研究较少。我们调查了 143 名年龄在 54-78 岁的 PLWH 中心理社会因素（情绪、孤独和耻辱感）、炎症标志物与与年龄相关的健康结果之间的横断面关系。
参与者提供血清细胞因子和 C 反应蛋白（CRP）分析的血液样本，完成评估心理社会因素和健康的调查，并完成虚弱评估。回归模型测试了关键心理社会、炎症和与年龄相关的健康变量之间的关系，同时调整了相关的社会人口统计学和临床因素。
抑郁症状较多的参与者的复合细胞因子水平高于抑郁症状较少的参与者（β=0.22，t（126）=2.71，p=0.008）。细胞因子水平较高的人更容易出现虚弱前期或虚弱（调整后的优势比=1.72，95%置信区间=1.01-2.93），并且报告身体功能更差（β=-0.23，t（129）=-2.64，p=0.009）和更多认知投诉（β=-0.20，t（129）=-2.16，p=0.03）比细胞因子水平较低的人。CRP 与这些结果没有显著相关；6 个月的跌倒史与炎症标志物没有显著相关。
需要新的方法来管理老年 PLWH 的合并症并提高生活质量。我们的研究结果说明了关键的预期心理社会联系，强调了几个可能与慢性炎症（驱动发病率的关键因素）具有双向关系的因素（例如，抑郁症状、较差的身体功能）。这些联系可能被利用来改变导致老年 PLWH 过度健康风险的因素。
