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Citation
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Sharma A, Hoover DR, Shi Q, Holman S, Plankey MW, Tien PC, Weber KM, Floris-Moore M, Bolivar HH, Vance DE, Golub ET, Holstad MM, Yin MT. Antivir. Ther. 2018; 23(2): 179-190. |
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Affiliation
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Department of Medicine, Columbia University Medical Center, New York, NY, USA. |
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Abstract
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BACKGROUND: Although fracture rates are higher in HIV+ than HIV- women, whether HIV infection increases risk of falls is unclear. We determined the longitudinal occurrence and risk factors for falls in the Women's Interagency HIV Study (WIHS), and explored associations with cognitive complaints.
METHODS: Recent (prior 6 months) self-reported falls were collected in 1816 (1250 HIV+; 566 HIV-) women over 24 months. Generalized estimating equation models using stepwise selection determined odds of any fall (vs. none).
RESULTS: HIV+ women were older than HIV- women (median 49 vs. 47yrs, p=0.0004), more likely to report neuropathy (20% vs. 16%, p=0.023), and had greater central nervous system (CNS) medication use. At least one fall was reported in 41% HIV+ vs. 42% HIV- women, including ≥2 falls in 25% HIV+ and 24% HIV- (overall p =0.30). Cognitive complaints were associated with falls among HIV+ [odds ratio (OR) 2.38; 95% CI: 1.83-3.09] and HIV- women (OR 3.43; 95% CI: 2.37-4.97); in adjusted models, cognitive complaints remained significant only in HIV- women [adjusted (aOR) 2.26; 95%CI: 1.46, 3.48)]. Factors associated with any fall in adjusted analyses included: depressive symptoms and neuropathy (both HIV+ and HIV-); age, marijuana use, multiple CNS medications, and hepatitis C virus infection (HIV+ only); and cognitive complaints, quality of life, hypertension, and obesity (HIV- only).
CONCLUSIONS: Middle-aged HIV+ and HIV- women had similar fall rates. Among HIV+ women, factors affecting cognition such as age, depressive symptoms, marijuana use, and multiple CNS medications were important predictors of falls, however cognitive complaints were not.
Language: en |