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A new frailty syndrome: central obesity and frailty in older adults with the human immunodeficiency virus.
J Am Geriatr Soc 2012; 60(3):545-9JA

Abstract

OBJECTIVES

To evaluate the relationships between body composition and physical frailty in community-dwelling older adults with the human immunodeficiency virus (HIV) (HOA).

DESIGN

Cross-sectional.

SETTING

Academic hospital-based infectious disease clinic in Rochester, New York.

PARTICIPANTS

Forty community-dwelling HOA aged 50 and older undergoing antiretroviral therapy who were able to ambulate without assistive devices with a mean age of 58, a mean BMI of 29.0 kg/m(2), mean CD4 count of 569 cells/mL, and a mean duration since HIV diagnosis of 17 years; 28% were female and 57% Caucasian.

MEASUREMENTS

Subjective and objective measures of functional status were evaluated using the Physical Performance Test (PPT), the graded treadmill test, knee strength, gait speed, balance, and the Functional Status Questionnaire (FSQ). Body composition was evaluated using dual-energy X-ray absorptiometry (DXA) and magnetic resonance imaging (MRI).

RESULTS

Sixty percent (25/40) of the participants met standard criteria for physical frailty. Frail (FR) and nonfrail (NF) participants were comparable in age, sex, CD4 count, and viral load. FR HOA had greater impairments in PPT, peak oxygen uptake, FSQ, walking speed, balance, and muscle quality than NF HOA. FR HOA had a greater body mass index (BMI), fat mass, and truncal fat with lipodystrophy. Moreover, PPT score was inversely related to trunk fat (correlation coefficient (r) = -0.34; P = .04) and ratio of intermuscular fat to total fat (r = -0.60; P = .02) after adjusting for covariates.

CONCLUSION

HOA represent an emerging cohort of older adults who frequently experience frailty at a much younger age than the general older population. Central obesity and fat redistribution are important predictors of frailty in community-dwelling HOA. These findings suggest that physical frailty in HOA may be amenable to lifestyle interventions, especially exercise and diet therapy.

Authors+Show Affiliations

Division of Geriatrics and Aging, Highland Hospital, School of Medicine and Dentistry, University of Rochester, Rochester, New York 14692, USA. krupa_shah@urmc.rochester.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

22315957

Citation

Shah, Krupa, et al. "A New Frailty Syndrome: Central Obesity and Frailty in Older Adults With the Human Immunodeficiency Virus." Journal of the American Geriatrics Society, vol. 60, no. 3, 2012, pp. 545-9.
Shah K, Hilton TN, Myers L, et al. A new frailty syndrome: central obesity and frailty in older adults with the human immunodeficiency virus. J Am Geriatr Soc. 2012;60(3):545-9.
Shah, K., Hilton, T. N., Myers, L., Pinto, J. F., Luque, A. E., & Hall, W. J. (2012). A new frailty syndrome: central obesity and frailty in older adults with the human immunodeficiency virus. Journal of the American Geriatrics Society, 60(3), pp. 545-9. doi:10.1111/j.1532-5415.2011.03819.x.
Shah K, et al. A New Frailty Syndrome: Central Obesity and Frailty in Older Adults With the Human Immunodeficiency Virus. J Am Geriatr Soc. 2012;60(3):545-9. PubMed PMID: 22315957.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A new frailty syndrome: central obesity and frailty in older adults with the human immunodeficiency virus. AU - Shah,Krupa, AU - Hilton,Tiffany N, AU - Myers,Lauren, AU - Pinto,Jonathan F, AU - Luque,Amneris E, AU - Hall,William J, Y1 - 2012/02/08/ PY - 2012/2/10/entrez PY - 2012/2/10/pubmed PY - 2012/5/5/medline SP - 545 EP - 9 JF - Journal of the American Geriatrics Society JO - J Am Geriatr Soc VL - 60 IS - 3 N2 - OBJECTIVES: To evaluate the relationships between body composition and physical frailty in community-dwelling older adults with the human immunodeficiency virus (HIV) (HOA). DESIGN: Cross-sectional. SETTING: Academic hospital-based infectious disease clinic in Rochester, New York. PARTICIPANTS: Forty community-dwelling HOA aged 50 and older undergoing antiretroviral therapy who were able to ambulate without assistive devices with a mean age of 58, a mean BMI of 29.0 kg/m(2), mean CD4 count of 569 cells/mL, and a mean duration since HIV diagnosis of 17 years; 28% were female and 57% Caucasian. MEASUREMENTS: Subjective and objective measures of functional status were evaluated using the Physical Performance Test (PPT), the graded treadmill test, knee strength, gait speed, balance, and the Functional Status Questionnaire (FSQ). Body composition was evaluated using dual-energy X-ray absorptiometry (DXA) and magnetic resonance imaging (MRI). RESULTS: Sixty percent (25/40) of the participants met standard criteria for physical frailty. Frail (FR) and nonfrail (NF) participants were comparable in age, sex, CD4 count, and viral load. FR HOA had greater impairments in PPT, peak oxygen uptake, FSQ, walking speed, balance, and muscle quality than NF HOA. FR HOA had a greater body mass index (BMI), fat mass, and truncal fat with lipodystrophy. Moreover, PPT score was inversely related to trunk fat (correlation coefficient (r) = -0.34; P = .04) and ratio of intermuscular fat to total fat (r = -0.60; P = .02) after adjusting for covariates. CONCLUSION: HOA represent an emerging cohort of older adults who frequently experience frailty at a much younger age than the general older population. Central obesity and fat redistribution are important predictors of frailty in community-dwelling HOA. These findings suggest that physical frailty in HOA may be amenable to lifestyle interventions, especially exercise and diet therapy. SN - 1532-5415 UR - https://www.unboundmedicine.com/medline/citation/22315957/A_new_frailty_syndrome:_central_obesity_and_frailty_in_older_adults_with_the_human_immunodeficiency_virus_ L2 - https://doi.org/10.1111/j.1532-5415.2011.03819.x DB - PRIME DP - Unbound Medicine ER -