Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, MC5723, 401 Quarry Road, Stanford, CA, USA.
Center for Health Sciences, SRI International, Menlo Park, CA, USA.
J Neuroimmune Pharmacol. 2022 Dec;17(3-4):538-552. doi: 10.1007/s11481-021-10039-y. Epub 2022 Jan 8.
People living with HIV infection (PWH) who are adequately treated pharmacologically are now likely to have a near normal life span. Along with this benefit of the aging HIV population are potential physical problems attendant to aging, including postural stability. Whether aging with HIV accelerates age-related liability for postural instability and what sensory factors contribute to imbalance were examined in 227 PWH and 137 people living without HIV (PWoH), age 25 to 75 years. A mixed cross-sectional/longitudinal design revealed steeper aging trajectories of the PWH than PWoH in sway path length, measured as center-of-pressure micro-displacements with a force platform while a person attempted to stand still. Sway paths were disproportionately longer for PWH than PWoH when tested with eyes closed than open. Multiple regression identified objective measures of sensory perception as unique predictors of sway path length, whereas age, sway path length, and self-reports of falls were predictors of standing on one leg, a common measure of ataxia. Knowledge about sensory signs and symptoms of imbalance in postural stability with and without visual information may serve as modifiable risk factors for averting instability and liability for falls in the aging HIV population.
现在，经过充分药物治疗的 HIV 感染者（PWH）很可能拥有接近正常的寿命。随着 HIV 老龄化人群的这一获益，可能会出现与衰老相关的潜在身体问题，包括姿势稳定性。本研究旨在探究 HIV 感染者衰老是否会加速与年龄相关的姿势不稳定易感性，以及哪些感觉因素会导致平衡失调。研究纳入了 227 名 HIV 感染者和 137 名未感染 HIV 的人群（PWoH），年龄 25-75 岁。混合横断面/纵向设计结果显示，与 PWoH 相比，HIV 感染者的身体晃动路径长度（通过力平台测量的压力中心微位移来评估）呈现更陡峭的衰老轨迹。当闭眼测试时，HIV 感染者的晃动路径长度明显长于 PWoH，而睁眼测试时，HIV 感染者的晃动路径长度与 PWoH 没有差异。多元回归分析结果显示，感觉知觉的客观测量指标是晃动路径长度的唯一预测因子，而年龄、晃动路径长度和跌倒自我报告是单腿站立（一种常用的共济失调测量方法）的预测因子。了解姿势稳定性的感觉迹象和症状，无论是在有或无视觉信息的情况下，都可能成为避免 HIV 老龄化人群不稳定和跌倒风险的可改变的危险因素。
