| |
Prevalence and correlates of frailty among
older people with and without HIV in rural Uganda
|
| |
| |
Download the PDF here
August 22, 2024
Similar to other studies from sub-Saharan Africa and elsewhere, we found frailty to be more common in people with depression9,36,37 and participants with one or more comorbidities9,26 whereas frailty or pre-frailty was more common among women16,18,19,38 in addition to participants with a positive depression screen. Depression and frailty are interlinked, with each condition being a risk factor for the development of the other.37,39 The finding of comorbidities as an association is of concern because we used self- reported comorbidities in a setting with relatively sparse preventive health care, which may have underestimated the actual prevalence of comorbidity.
In summary, we found that older PWH in rural Uganda had a similar prevalence of frailty and lower rates of pre-frailty than PWOH. Factors contributing to this shift toward better health among older PWH in sub-Saharan Africa require further study.
Abstract
Background:
The relationship between HIV and frailty, a predictor of poor outcomes in the face of stressors, remains unknown in older people in sub-Saharan Africa.
Methods:
We analysed data from the Quality of Life and Ageing with HIV in Rural Uganda cohort study to estimate the prevalence and correlates of frailty among older people with HIV (PWH) on long-term antiretroviral therapy and among age and sex-similar HIV-uninfected comparators. Frailty was defined as a self-report of 3 or 4 (and pre-frailty as 1 or 2) of the following phenotypic variables: weight loss, exhaustion, low activity, and slowness. We estimated the prevalence of frailty and pre-frailty and fitted logistic regression models to estimate the association between HIV and frailty, adjusting for sociodemographic factors, depression, and other comorbidities.
Results:
We enrolled 599 participants (49% women) with a mean age of 58 years. PWH had a similar prevalence of frailty (8.1% vs. 10.9%, p=0.24) but a lower prevalence of pre-frailty (54.2% vs. 63.2%, p=0.03) compared with their HIV-uninfected comparators. In multivariable regression models, people with depression (AOR 7.52 [95% CI: 3.67-15.40], p<0.001) and those with ≥1 comorbidities (AOR 3.15 [95% CI: 1.71-3.82], p<0.001) were more likely to be frail. HIV serostatus was not significantly associated with frailty (AOR 0.71 [95% CI: 0.37-1.34], p=0.29).
Conclusion:
Older PWH had a similar prevalence of frailty as those without HIV. These findings call for additional study of the factors that contribute to the robustness of older PWH in sub-Saharan Africa.
|
|
| |
| |
|
|
|
