School of Medicine, University of Washington, Seattle, Washington, USA.
School of Nursing, University of Washington, Seattle, Washington, USA.
J Assoc Nurses AIDS Care. 2024;35(1):e1-e2. doi: 10.1097/JNC.0000000000000445.
“Sick quitting”, a phenomenon describing reductions in alcohol consumption following poor health, may explain observations that alcohol appears protective for frailty risk. We examined associations between frailty and reductions in drinking frequency among people with HIV (PWH). At six Centers for AIDS Research Network of Integrated Clinical Systems (CNICS) sites between January 2012 and August 2021, we assessed whether frailty, measured via validated modified frailty phenotype, precedes reductions in drinking frequency. We associated time-updated frailty with quitting and reducing frequency of any drinking and heavy episodic drinking (HED), adjusted for demographic and clinical characteristics in Cox models. Among 5,654 PWH reporting drinking, 60% reported >monthly drinking and 18% reported ≥monthly HED. Over an average of 5.4 years, frail PWH had greater probabilities of quitting (HR:1.56, 95%CI:1.13–2.15) and reducing (HR:1.35, 95%CI:1.13–1.62) drinking frequency, as well as reducing HED frequency (HR:1.58, 95%CI:1.20–2.09) vs. robust PWH. Sick quitting likely confounds the association between alcohol use and frailty risk, requiring investigation for control.
“因病戒酒”是指健康状况不佳导致饮酒量减少的现象，这可能可以解释为什么有人观察到饮酒似乎可以降低衰弱风险。我们研究了衰弱与艾滋病毒感染者（PLWH）饮酒频率降低之间的关系。在 2012 年 1 月至 2021 年 8 月期间，我们在六个艾滋病研究中心网络综合临床系统（CNICS）站点检查了衰弱是否通过经过验证的改良衰弱表型来预测饮酒频率降低。我们通过 Cox 模型，将时间更新的衰弱与戒酒和减少任何饮酒以及重度饮酒（HED）的频率相关联，同时调整了人口统计学和临床特征。在报告饮酒的 5654 名 PLWH 中，60%的人报告每月饮酒次数>1 次，18%的人报告每月 HED 饮酒次数≥1 次。在平均 5.4 年的时间里，衰弱的 PLWH 戒酒（HR：1.56，95%CI：1.13–2.15）和减少（HR：1.35，95%CI：1.13–1.62）饮酒频率以及减少 HED 频率（HR：1.58，95%CI：1.20–2.09）的可能性均高于健康的 PLWH。“因病戒酒”可能会混淆饮酒与衰弱风险之间的关系，需要进行研究以进行控制。
