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Citation
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Sharma A, Hoover DR, Shi Q, Gustafson DR, Plankey MW, Tien PC, Weber KM, Yin MT. Antivir. Ther. 2019; 24(1): 51-61. |
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Affiliation
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Department of Medicine, College of Physicians and Surgeons, Columbia University Medical Center, New York, NY, USA. |
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Abstract
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BACKGROUND: Frailty and falls occur commonly and prematurely in HIV-infected populations. Whether frailty in middle-age predicts future falls among HIV-infected women is unknown.
METHODS: We evaluated associations of frailty with single and recurrent falls 10 years later among 729 HIV-infected and 326 uninfected women in the Women's Interagency HIV Study (WIHS) with frailty measured in 2005 and self-reported falls in 2014-2016. Frailty was defined as ≥3 of 5 Fried Frailty Index components: slow gait, reduced grip strength, exhaustion, unintentional weight loss, and low physical activity. Stepwise logistic regression models determined odds of single (vs. 0) or recurrent falls (≥2 vs. 0) during the two-year period; separate models evaluated frailty components.
RESULTS: HIV-infected women were older (median 42 vs. 39 yr, p<0.0001) and more often frail (14% vs. 9%, p=0.04) than uninfected women. Over two years, 40% of HIV-infected vs. 39% of uninfected women reported a fall [single fall in 15% HIV+ vs. 18% HIV- women; recurrent falls in 25% HIV+ vs. 20% HIV- women (overall p =0.20)]. In multivariate models, frailty independently predicted recurrent falls [adjusted odds ratio (aOR) 1.84, 95% CI: 1.13-2.97, p=0.01], but not single fall. Among frailty components, unintentional weight loss independently predicted single fall (aOR 2.31, 95% CI: 1.28- 4.17, p=0.005); unintentional weight loss (aOR 2.26, 95% CI: 1.32-3.86, p= 0.003) and exhaustion (aOR 1.66, 95% CI: 1.10- 2.50, p=0.02) independently predicted recurrent falls.
CONCLUSIONS: Early frailty measurement among middle-aged women with or at-risk for HIV may be a useful tool to assess future fall risk.
Language: en |