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Clin Infect Dis. 2018 Dec 24. doi: 10.1093/cid/ciy1101. [Epub ahead of print]

Frailty is an independent risk factor for mortality, cardiovascular disease, bone disease and diabetes among aging adults with HIV.

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Vanderbilt University Medical Center, Nashville, TN, USA.
Harvard School of Public Health, Boston, MA, USA.
University of Colorado School of Medicine, Denver, CO, USA.
The Ohio State University Wexner Medical Center, Columbus, OH, USA.
Northwestern University Feinberg School of Medicine, Chicago, IL, USA.



We characterized associations between frailty and incidence of cardiovascular disease (CVD), diabetes mellitus (DM), bone disease and mortality within a cohort of aging persons with HIV (PWH).


Participants underwent frailty evaluations using the Fried's frailty assessment at baseline and then annually. Frailty was defined as having ≥3 frailty criteria. Clinical outcomes of mortality, incident CVD events, DM, and bone disease events were recorded throughout the study period (baseline to most recent study or clinic visit, or date of clinical outcome occurrence, whichever came first). Poisson regression models evaluated associations between baseline frailty, change in frailty score over 48 weeks, and each clinical outcome.


Among 821 men and 195 women (median age 51 years), 62 (6%) were frail at baseline. Frailty scores increased in one or more components among 194 participants (19%) from baseline to 48 weeks. Baseline frailty was associated with an increased risk of incident CVD and DM with a trend towards a significant association with incident bone events. Among the components of frailty, slow gait speed was associated with incident DM and borderline-associated with incident CVD. An increase in frailty from baseline to week 48 was associated with mortality, but not with the other clinical outcomes.


Baseline frailty was associated with multiple adverse health outcomes (incident CVD, DM and bone disease), while increase in frailty score was associated with mortality among PWH engaged in care. Incorporation of frailty assessments into the routine care of PWH may assist in improvement of functional status and risk stratification for age-related chronic diseases.


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