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Ruth M. Rothstein CORE Center and Cook County Health
HIV Integrated Program launch 'CORE Healthy Aging Initiative 2.0'
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Cook County Health
Updated 1/15/2019 7:41 AM
In 2018, 920 people aged 60 years or older living with HIV received primary are at the Ruth M. Rothstein CORE Center. As people living with HIV age, a significant proportion are socially isolated and have little or no family support while dealing with increasing medical and psycho-social comorbidities, depression, frailty, food insecurities, housing and transportation issues and coordinating insurance benefits and services.
In 2016, Cook County Health (CCH) led a research study that showed many aging HIV positive patients lived alone, and the interplay of co-morbidities, polypharmacy, memory issues and falls placed them at an increased risk for non-independent living at an earlier age than the general population. In November 2018, the CORE Center was awarded a three-year grant to make the CORE Healthy Aging Initiative (CHAI) expansion project a reality starting in January 2019.
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IDWeek 2016: Assessing the needs of older HIV+ adults; Initial data from the CORE Healthy Aging Initiative (CHAI) - Money, Mental Health, Housing Top List of Concerns in Older HIV+ Chicago Group
"Many aging HIV+ patients live alone, and the interplay of co-morbidities, poly-pharmacy, memory issues, and falls places them at an increased risk for non-independent living at an earlier age than the general population......median age stood at 56 years.....40% reported mental health is a concern...42% reported a history of depression.....One third reported memory problems or concerns, and 27% reported one or more falls in the past 12 months.....46%, lived alone.....54% took four or more prescription medicines daily"
in a 2nd study from Chicago at IDWeek 2018:
The CORE Center investigators cautioned that impaired immune restoration and comorbidity in an aging HIV population "portend a higher risk of non-AIDS morbidity and mortality."
Analysis of 675 virally suppressed people 60 or older showed that 70% had a low CD4/CD8 ratio (below 1) and one third had a very low ratio (below 0.5) [1]. Coronary artery disease and chronic kidney disease were more prevalent in people with a low CD4/CD8 ratio.
In 60-Year-Plus HIV Group With Viral Suppression, 70% Have Low CD4:CD8 Ratio
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CHAI 2.0 will directly focus on providing programs to the aging population at the CORE Center and improving provider and community awareness of the need to address aging related issues of people living with HIV. Participants will have access to aging related case management and peer navigation, insurance and benefits navigation and polypharmacy reduction interventions. Programming will also focus on healthy aging, stigma and social isolation reduction, including on/offsite support, events, virtual contact and will train patients to self-advocate.
This year marks the 20th anniversary of the CORE Center. The CORE Center was established as a partnership between CCH and Rush University Medical Center. Since its opening in 1998, the Center has remained one of the largest HIV/AIDS clinics in the U.S. and treats more than 10,000 patients annually for HIV/AIDS care and other infectious diseases.
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