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Gait Speed Decline Is Associated with Hemoglobin A1C, Neurocognitive Impairment, and Black Race in Persons with HIV.
AIDS Res Hum Retroviruses. 2019 Nov/Dec; 35(11-12):1065-1073.AR

Abstract

Gait speed declines at a faster rate in persons with HIV (PWH) than in the general population but the risk factors associated with this decline are not well understood. In the AIDS Clinical Trials Group (ACTG) A5322 (HAILO, HIV Infection, Aging, and Immune Function Long-term Observational Study), an observational cohort study of PWH ≥40 years of age, those who developed slow gait during the first 3 years of follow-up were compared with persons who maintained normal speed. Associations with demographic and clinical covariates were assessed using multivariable logistic regression. Of 929 participants, 81% were men, 31% Black, and 20% Hispanic. Median age was 51 years [interquartile range (IQR) = 46-56]. At study entry, 92% had plasma HIV RNA <50 copies/mL with median CD4 count 631 cells/mm3 (IQR = 458-840). At study entry, 7% of participants had slow gait, 16% had neurocognitive impairment (NCI), and 12% had diabetes. Over 3 years, 87% maintained normal gait speed, 3% maintained a slow gait, 6% developed a slow gait, and 4% improved from slow to normal gait speed. In multivariable models, hemoglobin A1C (HbA1C) percentage, per one unit increase [odds ratio (OR) = 1.36; 95% confidence interval (CI) = 1.03-1.81; p = .033], NCI (OR = 3.47; 95% CI = 1.57-7.69 p = .002), and black versus white race (OR = 2.45; 95% CI = 1.08-5.59; p = .032) at entry were significantly associated with development of slow gait compared with those maintaining normal gait speed. The association between baseline HbA1C and development of slow gait speed highlights an intervenable target to prevent progression of physical function limitations.

Authors+Show Affiliations

Division of Infectious Diseases, Northwestern University, Chicago, Illinois.Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts.Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts.Division of AIDS, DHHS/NIH/NIAID/DAIDS, Rockville, Maryland.Department of Neurosciences, University of California, San Diego, California.Mailman School of Public Health, Columbia University, New York, New York.Division of Endocrinology, Diabetes, & Metabolism, Johns Hopkins University, Baltimore, Maryland.Division of Infectious Diseases, Northwestern University, Chicago, Illinois.Departments of Medicine and Epidemiology, University of Colorado, Aurora, Colorado.

Pub Type(s)

Journal Article
Observational Study
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

31468979

Citation

Masters, Mary Clare, et al. "Gait Speed Decline Is Associated With Hemoglobin A1C, Neurocognitive Impairment, and Black Race in Persons With HIV." AIDS Research and Human Retroviruses, vol. 35, no. 11-12, 2019, pp. 1065-1073.
Masters MC, Perez J, Tassiopoulos K, et al. Gait Speed Decline Is Associated with Hemoglobin A1C, Neurocognitive Impairment, and Black Race in Persons with HIV. AIDS Res Hum Retroviruses. 2019;35(11-12):1065-1073.
Masters, M. C., Perez, J., Tassiopoulos, K., Andrade, A., Ellis, R., Yang, J., Brown, T. T., Palella, F. J., & Erlandson, K. M. (2019). Gait Speed Decline Is Associated with Hemoglobin A1C, Neurocognitive Impairment, and Black Race in Persons with HIV. AIDS Research and Human Retroviruses, 35(11-12), 1065-1073. https://doi.org/10.1089/AID.2019.0101
Masters MC, et al. Gait Speed Decline Is Associated With Hemoglobin A1C, Neurocognitive Impairment, and Black Race in Persons With HIV. AIDS Res Hum Retroviruses. 2019 Nov/Dec;35(11-12):1065-1073. PubMed PMID: 31468979.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Gait Speed Decline Is Associated with Hemoglobin A1C, Neurocognitive Impairment, and Black Race in Persons with HIV. AU - Masters,Mary Clare, AU - Perez,Jeremiah, AU - Tassiopoulos,Katherine, AU - Andrade,Adriana, AU - Ellis,Ronald, AU - Yang,Jingyan, AU - Brown,Todd T, AU - Palella,Frank J,, Jr AU - Erlandson,Kristine M, Y1 - 2019/09/30/ PY - 2019/8/31/pubmed PY - 2020/9/10/medline PY - 2019/8/31/entrez KW - aging KW - gait speed KW - hemoglobin A1C KW - neurocognitive impairment SP - 1065 EP - 1073 JF - AIDS research and human retroviruses JO - AIDS Res Hum Retroviruses VL - 35 IS - 11-12 N2 - Gait speed declines at a faster rate in persons with HIV (PWH) than in the general population but the risk factors associated with this decline are not well understood. In the AIDS Clinical Trials Group (ACTG) A5322 (HAILO, HIV Infection, Aging, and Immune Function Long-term Observational Study), an observational cohort study of PWH ≥40 years of age, those who developed slow gait during the first 3 years of follow-up were compared with persons who maintained normal speed. Associations with demographic and clinical covariates were assessed using multivariable logistic regression. Of 929 participants, 81% were men, 31% Black, and 20% Hispanic. Median age was 51 years [interquartile range (IQR) = 46-56]. At study entry, 92% had plasma HIV RNA <50 copies/mL with median CD4 count 631 cells/mm3 (IQR = 458-840). At study entry, 7% of participants had slow gait, 16% had neurocognitive impairment (NCI), and 12% had diabetes. Over 3 years, 87% maintained normal gait speed, 3% maintained a slow gait, 6% developed a slow gait, and 4% improved from slow to normal gait speed. In multivariable models, hemoglobin A1C (HbA1C) percentage, per one unit increase [odds ratio (OR) = 1.36; 95% confidence interval (CI) = 1.03-1.81; p = .033], NCI (OR = 3.47; 95% CI = 1.57-7.69 p = .002), and black versus white race (OR = 2.45; 95% CI = 1.08-5.59; p = .032) at entry were significantly associated with development of slow gait compared with those maintaining normal gait speed. The association between baseline HbA1C and development of slow gait speed highlights an intervenable target to prevent progression of physical function limitations. SN - 1931-8405 UR - https://www.unboundmedicine.com/medline/citation/31468979/Gait_Speed_Decline_Is_Associated_with_Hemoglobin_A1C_Neurocognitive_Impairment_and_Black_Race_in_Persons_with_HIV_ L2 - https://www.liebertpub.com/doi/10.1089/AID.2019.0101?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -