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Frailty is strongly associated with increased risk of recurrent falls among older HIV-infected adults.
AIDS. 2017 10 23; 31(16):2287-2294.AIDS

Abstract

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.

DESIGN

A prospective, multicenter cohort study of HIV-infected men and women aged at least 40 years.

METHODS

Frailty assessment included a 4-m 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-m 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.

RESULTS

Of 967 individuals, 6% were frail, 39% prefrail, and 55% nonfrail. Eighteen percent had at least one fall, and 7% had recurrent falls. In multivariable models, recurrent falls were more likely among frail (odds ratio 17.3, 95% confidence interval 7.03-42.6) and prefrail (odds ratio 3.80, 95% CI 1.87-7.72) than nonfrail 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.

CONCLUSION

Aging HIV-infected prefrail 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.

Authors+Show Affiliations

aHarvard T.H. Chan School of Public Health, Department of Epidemiology bHarvard T.H. Chan School of Public Health, Center for Biostatistics in AIDS Research, Boston, Massachusetts cOhio State University, Department of Internal Medicine; Columbus, Ohio dNorthwestern University Feinberg School of Medicine, Department of Medicine; Chicago, Illinois eMetroHealth and Louis Stokes Cleveland Veterans Administration Medical Center, Department of Medicine; Cleveland, Ohio fUniversity of Colorado-Anschutz Medical Campus, Department of Medicine, Aurora, Colorado, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

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

Language

eng

PubMed ID

28991026

Citation

Tassiopoulos, Katherine, et al. "Frailty Is Strongly Associated With Increased Risk of Recurrent Falls Among Older HIV-infected Adults." AIDS (London, England), vol. 31, no. 16, 2017, pp. 2287-2294.
Tassiopoulos K, Abdo M, Wu K, et al. Frailty is strongly associated with increased risk of recurrent falls among older HIV-infected adults. AIDS. 2017;31(16):2287-2294.
Tassiopoulos, K., Abdo, M., Wu, K., Koletar, S. L., Palella, F. J., Kalayjian, R., Taiwo, B., & Erlandson, K. M. (2017). Frailty is strongly associated with increased risk of recurrent falls among older HIV-infected adults. AIDS (London, England), 31(16), 2287-2294. https://doi.org/10.1097/QAD.0000000000001613
Tassiopoulos K, et al. Frailty Is Strongly Associated With Increased Risk of Recurrent Falls Among Older HIV-infected Adults. AIDS. 2017 10 23;31(16):2287-2294. PubMed PMID: 28991026.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Frailty is strongly associated with increased risk of recurrent falls among older HIV-infected adults. AU - Tassiopoulos,Katherine, AU - Abdo,Mona, AU - Wu,Kunling, AU - Koletar,Susan L, AU - Palella,Frank J,Jr AU - Kalayjian,Robert, AU - Taiwo,Babafemi, AU - Erlandson,Kristine M, PY - 2017/10/10/entrez PY - 2017/10/11/pubmed PY - 2018/5/31/medline SP - 2287 EP - 2294 JF - AIDS (London, England) JO - AIDS VL - 31 IS - 16 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. DESIGN: A prospective, multicenter cohort study of HIV-infected men and women aged at least 40 years. METHODS: Frailty assessment included a 4-m 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-m 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. RESULTS: Of 967 individuals, 6% were frail, 39% prefrail, and 55% nonfrail. Eighteen percent had at least one fall, and 7% had recurrent falls. In multivariable models, recurrent falls were more likely among frail (odds ratio 17.3, 95% confidence interval 7.03-42.6) and prefrail (odds ratio 3.80, 95% CI 1.87-7.72) than nonfrail 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. CONCLUSION: Aging HIV-infected prefrail 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. SN - 1473-5571 UR - https://www.unboundmedicine.com/medline/citation/28991026/Frailty_is_strongly_associated_with_increased_risk_of_recurrent_falls_among_older_HIV_infected_adults_ L2 - https://doi.org/10.1097/QAD.0000000000001613 DB - PRIME DP - Unbound Medicine ER -