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. 2015 Jun 1;69(2):161-7.
doi: 10.1097/QAI.0000000000000556.

Geriatric Syndromes in Older HIV-Infected Adults

Meredith Greene  1 , Kenneth E Covinsky, Victor Valcour, Yinghui Miao, Joy Madamba, Harry Lampiris, Irena Stijacic Cenzer, Jeffrey Martin, Steven G Deeks
Affiliations

Geriatric Syndromes in Older HIV-Infected Adults

Meredith Greene et al. J Acquir Immune Defic Syndr. .

Abstract

Background: Geriatric syndromes such as falls, frailty, and functional impairment are multifactorial conditions used to identify vulnerable older adults. Limited data exist on these conditions in older HIV-infected adults, and no studies have comprehensively examined these conditions.

Methods: Geriatric syndromes including falls, urinary incontinence, functional impairment, frailty, sensory impairment, depression, and cognitive impairment were measured in a cross-sectional study of HIV-infected adults aged 50 years and older who had an undetectable viral load on antiretroviral therapy. We examined both HIV and non-HIV-related predictors of geriatric syndromes including sociodemographics, number of comorbidities and nonantiretroviral medications, and HIV-specific variables in multivariate analyses.

Results: We studied 155 participants with a median age of 57 (interquartile range: 54-62) and 94% were men. Prefrailty (56%), difficulty with instrumental activities of daily living (46%), and cognitive impairment (47%) were the most frequent geriatric syndromes. Lower CD4 nadir incidence rate ratio [IRR: 1.16, 95% (confidence interval) CI: 1.06 to 1.26], non-white race (IRR: 1.38, 95% CI: 1.10 to 1.74), and increasing number of comorbidities (IRR: 1.09, 95% CI: 1.03 to 1.15) were associated with increased risk of having more geriatric syndromes.

Conclusions: Geriatric syndromes are common in older HIV-infected adults. Treatment of comorbidities and early initiation of antiretroviral therapy may help to prevent development of these age-related complications. Clinical care of older HIV-infected adults should consider incorporation of geriatric principles.

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Conflict of interest statement

Conflicts of Interest: Dr. Greene receives salary support from the National Institutes of Health (5-T32-AG000212). Drs. Deeks, Martin and Covinsky each currently hold grants from the National Institutes of Health. Dr. Valcour currently holds grants from the National Institutes of Health, and has served as a consultant and paid lecturer for IAS-USA. For the remaining authors no conflicts of interest were declared.

Figures

Figure 1
Figure 1. Frequencies of Geriatric Syndromes
Each bar reflects the percentage of participants with each geriatric syndrome. Actual percentages are shown at the end of each bar. Horizontal axis only shown to 60%. ADL= Activities of Daily Living, IADL= Instrumental Activities of Daily Living
Figure 2
Figure 2. Demographic and Clinical Factors Associated with Increasing Numbers of Geriatric Syndromes
Vertical axis shows each variable in the multivariate Poisson model. Horizontal bars reflect the Incidence Rate Ratio (IRR) with 95% Confidence Interval which are also listed on the right hand side of the figure (IRR, upper (UCL) and lower (LCL) 95% confidence intervals).
See this image and copyright information in PMC

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