Citation

Erlandson KM, Allshouse AA, Jankowski CM, Duong S, Mawhinney S, Kohrt WM, Campbell TB. J. Acquir. Immune Defic. Syndr. (LWW) 2012; 61(4): 484-489.

Affiliation

*Division of Infectious Diseases, Department of Medicine, University of Colorado Denver †Division of Geriatric Medicine, Department of Medicine, University of Colorado Denver ‡Department of Biostatistics and Informatics, University of Colorado Denver §Division of General Internal Medicine, Department of Medicine, University of Colorado Denver.

Copyright

(Copyright © 2012, Lippincott Williams and Wilkins)

DOI

10.1097/QAI.0b013e3182716e38

PMID

23143526

PMCID

PMC3496187

Abstract

BACKGROUND: : The incidence of and risk factors for falls in HIV-1-infected persons are unknown. METHODS: : Fall history during the prior 12 months, medical diagnoses, and functional assessments were collected on HIV-infected persons 45-65 years of age receiving effective antiretroviral therapy. Fall risk was evaluated using univariate and multivariate regression analyses. RESULTS: : Of 359 subjects, 250 persons (70%) reported no falls, 109 (30%) had ≥1 fall; and 66 (18%) were recurrent fallers. Females, whites, and smokers were more likely to be recurrent fallers (P ≤ 0.05). HIV-related characteristics including current and nadir CD4 T-cell count, estimated HIV duration, and Veterans Aging Cohort Study Index scores were not predictors of falls (all P ≥ 0.09); didanosine recipients were more likely to be recurrent fallers (P = 0.04). The odds of falling increased 1.7 for each comorbidity and 1.4 for each medication (P < 0.001) and were higher in persons with cardiovascular disease, hypertension, dementia, neuropathy, arthritis, chronic pain, psychiatric disease, frailty, or disability [all odds ratio (OR) ≥ 1.8; P ≤ 0.05]. Beta-blockers, antidepressants, antipsychotics, sedatives, and opiates were independently associated with falling (all OR ≥ 2.7; P ≤ 0.01). Female gender, diabetes, antidepressants, sedatives, opiates, didanosine, exhaustion, weight loss, and difficulty with balance were the most significant predictors of falls in logistic regression (all OR ≥ 2.5; P ≤ 0.05). CONCLUSIONS: : Middle-aged HIV-infected adults have high fall risk. Multiple comorbidities, medications, and functional impairment were predictive of falls, but surrogate markers of HIV infection or an HIV-specific multimorbidity index were not. Fall risk should be assessed routinely as part of the care of HIV-infected persons.

Language: en