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Frailty and resilience in people living with HIV during the COVID era: two complementary constructs? Sarcopenia, frailty & % of adipose tissue worsened. 37% were Frail & Non-Resilient
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International HIV & Aging Workshop 23-24 September 2021
Giovanni Guaraldi, MD. Università di Modena. Modena Metabolic Clinic.
Progression of frailty among HIV at clinic accelerated during COVID see graph below.
37% were Frail & Non-Resilient, 42% Fit & Non-Resilient, 12% Fit & Resilient, 8.7% Frail & Resilient: loneliness, multimorbidity, HIV duration, nadir CD4 and age were associated with the worst outcome of being frail & non resilient.
Being frail seemed to drive the worst outcomes of (low quality-of-life) energy & vitality, emotional well-being, general health, physical functioning & emotional problems.
Non-Resilience seems drive the worst outcomes, low quality-of-life in logistic regression model.
"Something bad happened last year, 14% were lost in care….how to depict the most vulnerable & how to reach them to keep them in care. when we speak about vulnerability we speak about frailty, its synonymous to frailty. People with HIV appear to have an increased risk of moving to pre-frailty or frailty compared to HIB negative people. In the past years observed frailty phenotype increased from 3% to 7.6% in our population in just 1 year, this was associated with decreased physical activity over the last year during COVID, it was associated with increased adipose tissue and a an even greater burden of sarcopenia…aging process in HIV may be accelerated. Frail & non resilient PWH will never recover from the impact of COVID or it might take a very long time."
I would like to convince you that Frailty and resilience should be evaluated simultaneously in PLWH to identify vulnerable individuals.
webcast: https://www.youtube.com/watch?v=vi4XGEsWDqo
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