Frailty is considerably more common among middle-aged people living with HIV than their HIV-negative counterparts, and is strongly predictive of mortality or incident comorbidity, new research published in Journal of Infectious Diseases affirms. That said, frailty is no stronger a predictor of adverse outcomes among people living with HIV than among HIV-negative people, the study found.
Researchers analyzed data from the Dutch AGEhIV Cohort Study. A frailty index was assigned based on weight loss, low physical activity, exhaustion, decreased grip strength and slow gait speed, with participants who exhibited ≥ 3 of these characteristics considered frail.
While the study included 598 virally suppressed PLWH and 550 HIV-negative controls, absolute numbers of frail participants and deaths were relatively low (86 and 38, respectively). Twelve percent of the PLWH group and 3% of the HIV-negative group were considered frail at baseline. Frailty predicted mortality at an odds ratio of 5.3 independent of age, smoking, alcohol use, or serostatus.
Based on other evidence, physical activity may improve frailty in older people. The authors of the current study called for determining whether such interventions might be useful for younger PLWH, too. “Providing clear advice on what can be done to promote healthy aging and improve clinical outcomes for better quality of life will remain a high priority for PHIV and their providers for many years to come,” wrote James McMahon, Ph.D., M.P.H., M.B.B.S., and Jennifer Hoy, M.B.B.S., of Monash University in Melbourne, Australia, in a related commentary.