TY - JOUR PY - 2019// TI - Frailty predicts fractures among women with and at-risk for HIV JO - AIDS A1 - Sharma, Anjali A1 - Shi, Qiuhu A1 - Hoover, Donald R. A1 - Tien, Phyllis C. A1 - Plankey, Michael W. A1 - Cohen, Mardge H. A1 - Golub, Elizabeth T. A1 - Gustafson, Deborah A1 - Yin, Michael T. SP - 455 EP - 463 VL - 33 IS - 3 N2 - OBJECTIVE: To determine associations between frailty and fracture in women with and without HIV infection.

DESIGN: Prospective longitudinal cohort study evaluating associations between baseline frailty status and frailty components, with first and second incident fractures.

METHODS: We evaluated associations of frailty with fracture among 1332 women with HIV and 532 uninfected women without HIV. Frailty was defined as at least three of five Fried Frailty Index components: slow gait, reduced grip strength, exhaustion, unintentional weight loss, and low physical activity. Cox proportional hazards models determined predictors of time to first and second fracture; similar models evaluated Fried Frailty Index components.

RESULTS: Women with HIV were older (median 42 vs. 39 years, P < 0.0001) and more often frail (14 vs. 8%, P = 0.04) than women without HIV; median follow-up was 10.6 years. Frailty was independently associated with time to first fracture in women with and without HIV combined [adjusted hazard ratio (aHR) 1.71, 95% confidence interval (CI): 1.30-2.26; P = 0.0001], and among women with HIV only (aHR 1.91, 95% CI: 1.41-2.58; P < 0.0001), as well as with time from first to second fracture among women with HIV (aHR 1.86, 95% CI: 1.15-3.01; P = 0.01).

CONCLUSION: In this cohort of middle-aged racial and ethnic minority women with or at-risk for HIV, frailty was a strong and independent predictor of fracture risk. As women with HIV continue to age, early frailty screening may be a useful clinical tool to help identify those at greatest risk of fracture.

Language: en

LA - en SN - 0269-9370 UR - http://dx.doi.org/10.1097/QAD.0000000000002082 ID - ref1 ER -