Riassunto analitico
Abstract
Background
Currently, the impact of HIV and protective social-environmental conditions on frailty in HIV ageing population is not known. Aim of this study was to evaluate the relationship between frailty and HIV and social vulnerability using two health indexes previously developed by our group, HIV and Protective Indexes, (HIVI, PI).
Material and methods
This study was performed within the Modena HIV Metabolic Clinic (MHMC) prospective cohort Frailty was evaluated with a 72-items frailty index (FI). All patients with a FI score ≥ 0.25 were considered frail. HIVI and PI were built using commonly recollected HIV and social vulnerability data. Multivariate linear and logistic models were used to evaluate predictors of frailty among all variables and Indexes.
Results
1565 subjects were included. Mean age 53.15±8.03, 73.9% males. Mean FI was 0.19±0.08. Mean HIVI and PI were 0.48±0.17 and 0.63±0.14 respectively. independent predictors of frailty were: CDC class (OR=2.20, p< 0.001), duration of HIV (OR=3.86, p < 0.001), time from diagnosis to initiation of ART (OR=1.65, p = 0.002), lipodystrophy (OR=1.86, p = 0.001), current CD4+ (OR=1.66, p<0.001) and a higher HIVI score (OR=1.025, p<0.001). Protective factors were: higher years of education (OR=0.24, p<0.001), white collar profession (OR=0.41, p<0.001), higher income (OR=0.26, p<0.05), no history of injective drug use (OR=0.49, p<0.001), no smoking habit (OR=0.44 p < 0.001), physical activity (OR=2.94 p < 0.001) and a higher PI score (OR=0.972, p<0.001).
Conclusion
Our work suggests that HIV and social vulnerability factors contribute to frailty in an HIV ageing cohort. Interestingly, higher HIVI and lower PI scores correlate with frailty. Together FI, HIVI and PI may represent a comprehensive geriatric assessment in HIV ageing population.
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