Association between Frailty and HIV-Associated Neurodegenerative Disorders among Older Adults Living with HIV


Por: Zamudio-Rodríguez A., Belaunzarán-Zamudio P.F., Sierra-Madero J.G., Cuellar-Rodríguez J., Crabtree-Ramírez B.E., Alcala-Zermeno J.L., Amieva H., Avila-Funes J.A.

Publicada: 1 ene 2018
Resumen:
The population of aging adults living with human immunodeficiency virus (HIV) is growing worldwide and evidence suggests that frailty occurs prematurely among them. In turn, frailty has been associated with cognitive decline. It is unknown, however, if people with both frailty and HIV infection have a higher risk of cognitive impairment compared with nonfrail HIV-infected persons. Therefore, the main objective of this study was to determine the association between the phenotype of frailty and HIV-associated neurocognitive disorders (HAND) among adults aged 50 years or older living with HIV/AIDS. A cross-sectional study was conducted on 206 adults living with HIV receiving care in a university-affiliated tertiary care hospital in Mexico City. Frailty was defined as per the Fried criteria. The presence of HAND was established according to the Antinori criteria: HIV-associated asymptomatic neurocognitive impairment (ANI), HIV-associated mild neurocognitive disorder (MND), or cognitively nonimpaired. Multinomial logistic regression models were used to test the independent association between frailty and HAND adjusting for potential confounders. Mean age of participants was 60.5 ± 6.3 years and 84.9% were male. Prevalence of HAND and frailty phenotype was 66.0% and 2.9%, respectively. The unadjusted analysis showed that both prefrail and frail statuses were associated with MND but not with ANI. However, after adjustment, the association with MND remained significant only among prefrail participants and no longer for frail persons (risk ratio [RR] = 5.7, 95% confidence intervals [CI] 1.09-29.82; p = .039 and RR = 18.3, 95% CI 0.93-362.6; p = .056, respectively). Prefrailty is associated with symptomatic neurocognitive disorders in older adults living with HIV. The spectrum of the frailty phenotype in this already vulnerable population should serve as an indicator of concomitant cognitive decline. © Copyright 2018, Mary Ann Liebert, Inc. 2018.

Filiaciones:
Zamudio-Rodríguez A.:
 Department of Geriatrics, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Vasco de Quiroga 15, Tlalpan, Mexico City, CP 14080, Mexico

 Inserm, Bordeaux Population Health Research Center, UMR 1219, University Bordeaux, Bordeaux, France

Belaunzarán-Zamudio P.F.:
 Departamento de Infectología, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico

Sierra-Madero J.G.:
 Departamento de Infectología, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico

Cuellar-Rodríguez J.:
 Departamento de Infectología, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico

Crabtree-Ramírez B.E.:
 Departamento de Infectología, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico

Alcala-Zermeno J.L.:
 Department of Geriatrics, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Vasco de Quiroga 15, Tlalpan, Mexico City, CP 14080, Mexico

Amieva H.:
 Inserm, Bordeaux Population Health Research Center, UMR 1219, University Bordeaux, Bordeaux, France

Avila-Funes J.A.:
 Department of Geriatrics, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Vasco de Quiroga 15, Tlalpan, Mexico City, CP 14080, Mexico

 Inserm, Bordeaux Population Health Research Center, UMR 1219, University Bordeaux, Bordeaux, France
ISSN: 08892229
Editorial
MARY ANN LIEBERT, INC, 140 HUGUENOT STREET, 3RD FL, NEW ROCHELLE, NY 10801 USA, Estados Unidos America
Tipo de documento: Article
Volumen: 34 Número: 5
Páginas: 449-455
WOS Id: 000431182400008
ID de PubMed: 29385834