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J Acquir Immune Defic Syndr. 2015 Jun 1;69(2):161-7. doi: 10.1097/QAI.0000000000000556.

Geriatric Syndromes in Older HIV-Infected Adults.

Author information

1
*Division of Geriatrics, Department of Medicine, University of California San Francisco, San Francisco, CA; †Section of Geriatrics and Palliative Medicine, San Francisco Veterans Affairs Medical Center, San Francisco, CA; ‡Department of Neurology, University of California San Francisco, Memory and Aging Center, San Francisco, CA; §Division of HIV/AIDS, Department of Medicine, University of California San Francisco, San Francisco, CA; ‖Division of Infectious Diseases, Department of Medicine, University of California San Francisco, San Francisco, CA; ¶Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA; and #Section of Infectious Diseases, San Francisco Veterans Affairs Medical Center, San Francisco, CA.

Abstract

BACKGROUND:

Geriatric syndromes such as falls, frailty, and functional impairment are multifactorial conditions used to identify vulnerable older adults. Limited data exist on these conditions in older HIV-infected adults, and no studies have comprehensively examined these conditions.

METHODS:

Geriatric syndromes including falls, urinary incontinence, functional impairment, frailty, sensory impairment, depression, and cognitive impairment were measured in a cross-sectional study of HIV-infected adults aged 50 years and older who had an undetectable viral load on antiretroviral therapy. We examined both HIV and non-HIV-related predictors of geriatric syndromes including sociodemographics, number of comorbidities and nonantiretroviral medications, and HIV-specific variables in multivariate analyses.

RESULTS:

We studied 155 participants with a median age of 57 (interquartile range: 54-62) and 94% were men. Prefrailty (56%), difficulty with instrumental activities of daily living (46%), and cognitive impairment (47%) were the most frequent geriatric syndromes. Lower CD4 nadir incidence rate ratio [IRR: 1.16, 95% (confidence interval) CI: 1.06 to 1.26], non-white race (IRR: 1.38, 95% CI: 1.10 to 1.74), and increasing number of comorbidities (IRR: 1.09, 95% CI: 1.03 to 1.15) were associated with increased risk of having more geriatric syndromes.

CONCLUSIONS:

Geriatric syndromes are common in older HIV-infected adults. Treatment of comorbidities and early initiation of antiretroviral therapy may help to prevent development of these age-related complications. Clinical care of older HIV-infected adults should consider incorporation of geriatric principles.

PMID:
26009828
PMCID:
PMC4445476
DOI:
10.1097/QAI.0000000000000556
[Indexed for MEDLINE]
Free PMC Article

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