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FRAILTY AND PRE-FRAILTY IN A CONTEMPORARY COHORT OF HIV-INFECTED INDIVIDUALS IN THE SUN STUDY
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Reported by Jules Levin
CROI 2012 March 5-8 Seattle, WA
Nur F. Onen1, Pragna Patel2, Jason Baker3, Lois Conley2, John T. Brooks2, Tim Bush2, E. Milunka Kojic4, John Hammer5, E. Turner Overton1, for the SUN Study Investigators.
1Washington University School of Medicine, St. Louis, MO, 2Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, GA,3 University of Minnesota, Hennepin County Medical Center, Minneapolis, MN,4 Miriam Hospital, Providence, RI, 5 Denver Infectious Disease Consultants, Denver, CO
BACKGROUND
· Frailty is a state of diminished reserve and increased vulnerability due to cumulative accumulations in deficits in multiple physiological systems. It is usually seen in the 7th-8th decade of life (5-40% of elderly persons) and is associated with multi-morbidity, falls, fractures, institutionalization, social isolation and death.
· Pre-frailty is a sub-clinical intermediate state on a dynamic spectrum from non-frailty to frailty. It is prevalent in up to 50% of elderly persons and is a near-term risk factor for incident frailty.
· Frail HIV-infected persons are similarly vulnerable but prematurely so (4th to 5th decade of life, prevalence of 5-20%) and the prevalence and significance of pre-frailty in this population is unknown.
· We evaluated the prevalence and associated characteristics of pre-frailty and frailty among participants in the Study to Understand the Natural History of HIV and AIDS in the Era of Effective Therapy (SUN study).
TABLE 1. FACTORS INDEPENDENTLY ASSOCIATED WITH PRE-FRAIL/FRAIL VERSUS NON-FRAIL STATUS ON MULTI-VARIATE ANALYSIS
·a median, (interquartile range). b mean ± standard error of the mean. * Race/ethnicity breakdown - 179 (58%) white, non-Hispanic; 90 (29%) black, non-Hispanic; 31 (10%) Hispanic; 8 (3%) other/unknown. CKD, chronic kidney disease; STD, sexually transmitted diseases; cART; combination antiretroviral therapy; hs-CRP, high-sensitivity C-reactive protein; TNF-α, tumor necrosis factor alpha; IL-6, interleukin-6; sCD14, soluble CD14; 25 (OH), 25 hydroxy. Groups did not differ in education attainment, illicit drug use, serum alanine or aspartate transferase, interleukin-8, cystatin-C, leptin, insulin.
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