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The importance of exercise and physical activity in older adults with HIV, editorial to 'prevent accelerated aging'
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Lee, Daniel
PREVENTION ".....start developing exercise routine perhaps at a younger age (around age 40 years) to proactively counter the ongoing effects of HIV and its treatment on the aging process."
Excerpts
Given the potential for accelerated aging in PWH, it may be advisable to encourage PWH to start developing an exercise routine perhaps at a younger age (around age 40 years) to proactively counter the ongoing effects of HIV and its treatment on the aging process.
People with HIV (PWH) are living longer because of the ongoing improvements in highly active antiretroviral therapy (HAART) [1,2]. Naturally, a longer lifespan brings about the development and accumulation of comorbidities over time [3]. Anecdotally, it appears that PWH exhibit comorbidities and geriatric syndromes prematurely at younger ages than one might expect. Questions as to whether or not the aging process may be accelerated or accentuated in PWH have been posed [4]. Rickabaugh et al.[5] studied age-associated methylation patterns in PWH and estimated that HIV accelerated aging by approximately 14 years. Thus, with an accelerated aging process in PWH, one would expect to see the earlier onset of geriatric syndromes related to aging (such as falls, frailty, cognitive impairment, and depression) in PWH [6].
Reeds et al.[15] performed a study evaluating the use of a low-calorie diet (1000 kcal/day) in women with HIV and demonstrated a 14% reduction in VAT. A pilot study [16]evaluating the effect of exercise on body fat showed that exercise training may reduce trunk fat mass in men with HIV. Due to the increasing prevalence of aging-related conditions in PWH, such as frailty and sarcopenia, there has now been more interest in studying the effect of exercise in PWH [17-19].
In this issue of AIDS, Webel et al.[20] evaluated the relationship between objectively measured physical activity (via use of an accelerometer) and abdominal adiposity in PWH.
The majority (88%) of participants had excess abdominal adiposity based on waist circumference or waist-to-hip ratio. Accelerometry data revealed that 229 (55%) of the participants met the DHHS Physical Activity Guidelines [21] of 150 min of moderate-to-vigorous physical activity or 75 min of vigorous physical activity per week. Webel et al.[20] also reported that more steps per day was associated with a smaller waist circumference whereas sedentary behavior was associated with a larger waist circumference. Time spent in moderate-to-vigorous physical activity, however, was not associated with waist circumference.
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