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Frailty and physical performance assessments
as part of a comprehensive geriatric care model
in an urban HIV clinic: 73% Pre-frail or Frail 50% Weak
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Aging Workshop Oct 14-15 2022
Reported by Jules Levin
Eke, Uzoamaka1; Gruber-Baldini, Ann2; Mohanty, Kareshma3; Pandit, Neha4; Viviano, Nicole3; Palmeiro, Robyn5; Hoffmann, Jennifer D5; Judith Lee5; Schmalzle, Sarah1; Stafford, Kristen6,7.
1Division of Clinical Care and Research, Institute of Human Virology, University of Maryland School of Medicine, 2Division of Gerontology, Department of Epidemiology and Public Health, University of Maryland School of Medicine, 3University of Maryland Baltimore, 4University of Maryland School of Pharmacy, 5Institute of Human Virology, Clinical Division,
University of Maryland School of Medicine, 6Center for International Health, Education, and Biosecurity (CIHEB), Institute of Human Virology, University of Maryland School of Medicine, 7Department of Epidemiology and Public Health, University of Maryland School of Medicine
Participants were 56% male, 94% black, and the median age was 59 years (IQR 55-63). Most (78%) were virally suppressed (HIV viral load ≤40) and median CD4 count was 606 cells/μl (IQR 393-873).
Using FP, 62% were prefrail, 11% frail, and 27% robust. The most frequently occurring frailty components were weakness (51%), low walk speed (31%), shrinkage (21%), and low physical activity (17%). Exhaustion occurred in <5% of participants.
Using SPPB, majority (n=104, 63%) had low physical functioning (SPPB ≤9). Of these, 70 (67%) were pre-frail and 17% frail, using FP. All the FP frail patients had SPPB ≤9, which had a 100% sensitivity, 41% specificity, and 17% positive predictive value for FP frailty. In unadjusted analyses, polypharmacy(>5 pills), Montreal Cognitive Assessment (MoCA) score ≤18, Patient Health Questionnaire depression (PHQ-9) ≥5 and Generalized Anxiety Disorder (GAD-7) scores 5-9 and ≥10 were associated with frailty. In multivariate analyses, polypharmacy (OR 7.8, p=0.005), GAD ≥ 10 (OR 16.4, p=0.03) and MoCA≤18 (OR 24.3, p=0.03) remained statistically significant.
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