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老年人中 HIV 状态对运动和肺功能及移动能力残疾影响的种族差异。

Racial Differences in the Effect of HIV Status on Motor and Pulmonary Function and Mobility Disability in Older Adults.

机构信息

Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA.

Department of Preventive Medicine, Rush University Medical Center, Chicago, IL, USA.

出版信息

J Racial Ethn Health Disparities. 2022 Oct;9(5):1888-1896. doi: 10.1007/s40615-021-01126-0. Epub 2021 Aug 17.

Abstract

BACKGROUND

Older Black adults face a disproportionate burden of HIV prevalence, but less is known about racial disparities in age-related outcomes in HIV. We assessed the effect of HIV status and race on motor and pulmonary function, as well as how they contribute to mobility disability.

SETTING

Community-based study; Chicago, IL METHODS: Participants were 363 community-dwelling adults age ≥ 50 years, 48% living with HIV, and 68% Black. Participants with HIV were recruited from a specialty HIV clinic, and participants without HIV (comparable on key demographic, lifestyle, and behavioral characteristics) were recruited from the community. Measures included motor function summarized by 10 motor performance measures, pulmonary function summarized by 3 measures assessed using handheld spirometry, and self-reported mobility disability.

RESULTS

In fully adjusted linear models, HIV was associated with better motor (β = 9.35, p < 0.001) and pulmonary function (β = 16.34, p < 0.001). For pulmonary function, the effect of HIV status was moderated by race (interaction between Black race and HIV status: β =  - 11.66, p = 0.02), indicating that better pulmonary function among participants with HIV was less evident among Black participants. In fully adjusted models, odds of mobility disability did not differ by race, HIV status, or pulmonary function; better motor function was associated with lower odds of mobility disability (OR = 0.91 per 1-point higher, 95% CI 0.88-0.93).

CONCLUSION

Better motor and pulmonary function exhibited by participants with HIV could reflect access to medical care. Racial differences in lung function among participants with HIV indicate potential disparities in prevention or treatment of pulmonary disease or underlying risk factors.

摘要

背景

老年黑人群体面临着不成比例的 HIV 流行负担,但对于 HIV 相关年龄相关结果的种族差异知之甚少。我们评估了 HIV 状况和种族对运动和肺功能的影响,以及它们如何导致行动不便。

地点

基于社区的研究;伊利诺伊州芝加哥

方法

参与者是 363 名居住在社区中的年龄≥50 岁的成年人,其中 48%患有 HIV,68%为黑人。感染 HIV 的参与者是从专门的 HIV 诊所招募的,未感染 HIV 的参与者(在关键的人口统计学、生活方式和行为特征方面具有可比性)是从社区招募的。测量包括通过 10 项运动表现测量来总结的运动功能、通过使用手持式肺活量计评估的 3 项测量来总结的肺功能,以及自我报告的移动障碍。

结果

在完全调整的线性模型中,HIV 与更好的运动(β=9.35,p<0.001)和肺功能(β=16.34,p<0.001)相关。对于肺功能,HIV 状态的影响受到种族的调节(黑人种族和 HIV 状态之间的相互作用:β=-11.66,p=0.02),表明 HIV 感染者中更好的肺功能在黑人参与者中不太明显。在完全调整的模型中,移动障碍的几率不因种族、HIV 状态或肺功能而有所不同;更好的运动功能与较低的移动障碍几率相关(OR=每增加 1 分的 0.91,95%CI 0.88-0.93)。

结论

HIV 感染者表现出更好的运动和肺功能可能反映了他们获得医疗保健的机会。HIV 感染者中肺功能的种族差异表明,在预防或治疗肺部疾病或潜在风险因素方面可能存在差异。

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