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. 2021 Apr 30:13:467-474.
doi: 10.2147/HIV.S306532. eCollection 2021.

Aging-Related Concerns of People Living with HIV Referred for Geriatric Consultation

Eugenia L Siegler  1 , Jerad H Moxley  1 , Marshall J Glesby  2
Affiliations

Aging-Related Concerns of People Living with HIV Referred for Geriatric Consultation

Eugenia L Siegler et al. HIV AIDS (Auckl). .

Abstract

Purpose: People with HIV (PWH) are living longer lives and likely experiencing accentuated aging. Comprehensive geriatric assessment (CGA) has been proposed as a way to identify and help meet each individual patient's needs.

Patients and methods: We performed a retrospective review of the results of CGA in an HIV clinic in New York City. CGA included assessment of basic and instrumental activities of daily living, screens for depression, anxiety, frailty, cognition, and quality of life, along with general discussion of concerns and goals. We compared the group of PWH referred for CGA to those of comparable age who were not referred to determine the factors that were associated with referral. We carried out a descriptive analysis of those undergoing CGA, along with regression to determine factors associated with poorer PHQ-2 depression scores and higher VACS score.

Results: A total of 105 patients underwent full CGA during the study period. Mean age of referred patients was 66.5 years, ranging from 50 to 84 years (SD 7.99). More than 92% were virally suppressed. Compared with their non-referred counterparts over 50, referred patients were older and had more functional comorbidities like cerebrovascular disease, neuropathy, and urinary incontinence. More than half complained of fatigue, and 2/3 noted poor memory. Almost 60% were frail or prefrail. Ninety patients were asked about their goals, and the most commonly cited were related to health or finances; fifteen patients were unable to articulate any goals. Having fewer goals and noting weight loss or fatigue were predictive of higher scores on the PHQ-2 depression screen.

Conclusion: Although most older PWH undergoing CGA can manage their ADL, many have concerns and deficits beyond their comorbidities. CGA offers an important window into the psychosocial concerns and needs of older PWH.

Keywords: IADL; comorbidity; comprehensive geriatric assessment; frailty.

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Conflict of interest statement

Dr Glesby reports research support to Weill Cornell Medicine from Gilead Sciences and Regeneron; royalties from Springer and UpToDate. He is a consultant to ReAlta Life Sciences and Sobi. Dr Siegler has received research support to Weill Cornell Medicine from Gilead Sciences. She also reports philanthropic support for the HIV and Aging program from the Wayen Foundation. The authors report no other conflicts of interest in this work.

Figures

Figure 1
Figure 1
Topics discussed during initial comprehensive geriatric assessment.
Figure 2
Figure 2
Goals cited by patients during initial comprehensive geriatric assessment.
See this image and copyright information in PMC

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