Allavena Clotilde, Blain Hubert, Abulizi Xian, Slama Laurence, Katlama Christine, Delobel Pierre, Rio Vanessa, Cagnot Carole, Raho-Moussa Mariem, Makinson Alain, Meyer Laurence
Service de Maladies Infectieuses, UE 1413, CHU de Nantes, Université Nantes, Nantes.
Department of Internal Medicine and Geriatrics, University Hospital of Montpellier, Montpellier University, Centre Antonin Balmes, Montpellier.
AIDS. 2023 Jan 1;37(1):183-189. doi: 10.1097/QAD.0000000000003403. Epub 2022 Oct 11.
Frailty is a phenotype associated with adverse health outcomes in older persons. It has been evaluated mainly in middle-aged persons with HIV (PWH). The French multicenter prospective ANRS EP66 SEPTAVIH study aimed to assess frailty prevalence and risk factors in PWH aged 70 years or older on antiretroviral treatment (ART) for at least 12 months.
At baseline, Fried frailty phenotype criteria, sociodemographic data, medical/HIV history, functional status, comorbidities, including impaired cognitive function, depression, history of falls, and co-medications were collected. We measured the prevalence of frailty and compared the characteristics of frail versus prefrail and robust participants using univariate (Kruskal-Wallis tests for continuous variables and Chi 2 tests for categorical variables) and multivariate analyses.
Five hundred and ten PWH, mostly male (81.4%), were included with a median age of 73 years. The median HIV and ART durations were 22.7 years and 15.7 years, respectively. The prevalence of frailty was 13.5%, and of prefrailty 63.3%. In the multivariate analysis, increasing age [odds ratio (OR) 1.79 for each 5-year increment; 95% confidence interval (CI) 1.32-2.41], deprived socioeconomic status (OR 3.17; 95% CI 1.76-5.70), and multimorbidities (three or more) (OR 2.03; 95% CI 1.06-3.90) were associated with frailty.
A low prevalence of frailty was reported (13.5%) in PWH aged 70 years or older, whereas two-thirds of them were prefrail. Age, low socioeconomic status, and multimorbidities, but no HIV-related factors, were associated with frailty, suggesting the need to target these factors to help promoting successful aging in this population.
衰弱是一种与老年人不良健康结局相关的表型。其主要在中年HIV感染者(PWH)中进行评估。法国多中心前瞻性ANRS EP66 SEPTAVIH研究旨在评估70岁及以上接受抗逆转录病毒治疗(ART)至少12个月的PWH的衰弱患病率及危险因素。
在基线时,收集弗里德衰弱表型标准、社会人口统计学数据、医疗/HIV病史、功能状态、合并症,包括认知功能受损、抑郁、跌倒史及联合用药情况。我们测量了衰弱患病率,并使用单因素分析(连续变量采用Kruskal-Wallis检验,分类变量采用卡方检验)和多因素分析比较了衰弱、衰弱前期和健壮参与者的特征。
纳入了510例PWH,大多数为男性(81.4%),中位年龄为73岁。HIV感染和ART治疗的中位时长分别为22.7年和15.7年。衰弱患病率为13.5%,衰弱前期患病率为63.3%。在多因素分析中,年龄增长(每增加5岁,比值比[OR]为1.79;95%置信区间[CI]为1.32 - 2.41)、社会经济地位低下(OR为3.17;95% CI为1.76 - 5.70)以及多种合并症(三种或更多)(OR为2.03;95% CI为1.06 - 3.90)与衰弱相关。
据报告,70岁及以上PWH的衰弱患病率较低(13.5%),而其中三分之二处于衰弱前期。年龄、社会经济地位低下和多种合并症与衰弱相关,但与HIV相关的因素无关,这表明需要针对这些因素来帮助促进该人群的成功老龄化。