Frailty is strongly associated with increased risk of recurrent falls among older HIV-infected adults.

TitleFrailty is strongly associated with increased risk of recurrent falls among older HIV-infected adults.
Publication TypeJournal Article
Year of Publication2017
AuthorsTassiopoulos K, Abdo M, Wu K, Koletar SL, Palella FJ, Kalayjian R, Taiwo B, Erlandson KM
JournalAIDS
Volume31
Issue16
Pagination2287-2294
Date Published2017 10 23
ISSN1473-5571
Abstract

OBJECTIVE: Both frailty and falls occur at earlier-than-expected ages among HIV-infected individuals, but the contribution of frailty-to-fall risk in this population is not well understood. We examined this association among participants enrolled in AIDS Clinical Trials Group (ACTG) A5322.

DESIGN: A prospective, multicenter cohort study of HIV-infected men and women aged at least 40 years.

METHODS: Frailty assessment included a 4-m walk, grip strength, and self-reported weight loss, exhaustion, and low physical activity. Multinomial logistic regression assessed the association between baseline frailty, grip, and 4-m walk, and single and recurrent (2+) falls over the next 12 months; logistic regression assessed effect modification by several factors on association between frailty and any (1+) falls.

RESULTS: Of 967 individuals, 6% were frail, 39% prefrail, and 55% nonfrail. Eighteen percent had at least one fall, and 7% had recurrent falls. In multivariable models, recurrent falls were more likely among frail (odds ratio 17.3, 95% confidence interval 7.03-42.6) and prefrail (odds ratio 3.80, 95% CI 1.87-7.72) than nonfrail individuals. Significant associations were also seen with recurrent falls and slow walk and weak grip. The association between frailty and any falls was substantially stronger among individuals with peripheral neuropathy.

CONCLUSION: Aging HIV-infected prefrail and frail individuals are at significantly increased risk of falls. Incorporation of frailty assessments or simple evaluations of walk speed or grip strength in clinical care may help identify individuals at greatest risk for falls. Peripheral neuropathy further increases fall risk among frail persons, defining a potential target population for closer fall surveillance, prevention, and treatment.

DOI10.1097/QAD.0000000000001613
Alternate JournalAIDS
PubMed ID28991026
PubMed Central IDPMC5654616
Grant ListUM1 AI069494 / AI / NIAID NIH HHS / United States
UM1 AI069423 / AI / NIAID NIH HHS / United States
U01 AI069423 / AI / NIAID NIH HHS / United States
UM1 AI069432 / AI / NIAID NIH HHS / United States
K23 AG050260 / AG / NIA NIH HHS / United States
UM1 AI069471 / AI / NIAID NIH HHS / United States
R01 AG054366 / AG / NIA NIH HHS / United States
UM1 AI068634 / AI / NIAID NIH HHS / United States
R24 AI067039 / AI / NIAID NIH HHS / United States
U01 AI069432 / AI / NIAID NIH HHS / United States
U01 AI068636 / AI / NIAID NIH HHS / United States
UM1 AI069452 / AI / NIAID NIH HHS / United States
UM1 AI106701 / AI / NIAID NIH HHS / United States
U01 AI069494 / AI / NIAID NIH HHS / United States
U01 AI069452 / AI / NIAID NIH HHS / United States
P30 AI036219 / AI / NIAID NIH HHS / United States
U01 AI068634 / AI / NIAID NIH HHS / United States
UM1 AI068636 / AI / NIAID NIH HHS / United States