TY  - JOUR
PY  - 2019//
TI  - Frailty is strongly associated with increased risk of recurrent falls among older HIV-infected adults: a prospective cohort study
JO  - AIDS
A1  - Tassiopoulos, Katherine
A1  - Abdo, Mona
A1  - Wu, Kunling
A1  - Koletar, Susan L.
A1  - Palella, Frank J.
A1  - Kalayjian, Robert
A1  - Taiwo, Babafemi
A1  - Erlandson, Kristine M.
SP  - ePub
EP  - ePub
VL  - ePub
IS  - ePub
N2  - OBJECTIVE: Both frailty and falls occur at earlier than expected ages among HIV-infected individuals, but the contribution of frailty to fall risk in this population is not well understood. We examined this association among participants enrolled in AIDS Clinical Trials Group (ACTG) A5322. <br><br>DESIGN: A prospective, multi-center cohort study of HIV-infected men and women ≥40 years. <br><br>METHODS: Frailty assessment included a 4-meter walk, grip strength, and self-reported weight loss, exhaustion, and low physical activity. Multinomial logistic regression assessed the association between baseline frailty, grip, and 4-meter walk and single and recurrent (2+) falls over the next 12 months; logistic regression assessed effect modification by several factors on association between frailty and any (1+) falls. <br><br>RESULTS: Of 967 individuals, 6% were frail, 39% pre-frail, and 55% non-frail. Eighteen percent had ≥1 fall, and 7% had recurrent falls. In multivariable models, recurrent falls were more likely among frail (OR = 17.3; 95% CI = 7.03-42.6) and pre-frail (OR = 3.80; 95% CI = 1.87-7.72) than non-frail individuals. Significant associations were also seen with recurrent falls and slow walk and weak grip. The association between frailty and any falls was substantially stronger among individuals with peripheral neuropathy. <br><br>CONCLUSIONS: Aging HIV-infected pre-frail and frail individuals are at significantly increased risk of falls. Incorporation of frailty assessments or simple evaluations of walk speed or grip strength in clinical care may help identify individuals at greatest risk for falls. Peripheral neuropathy further increases fall risk among frail persons, defining a potential target population for closer fall surveillance, prevention, and treatment.<p />  <p>Language: en</p>
LA  - en
SN  - 0269-9370
UR  - http://dx.doi.org/10.1097/QAD.0000000000001613
ID  - ref1
ER  -