Anjali Sharma1, Donald R Hoover2, Qiuhu Shi3, Susan Holman4, Michael W Plankey5, Amber L Wheeler6, Kathleen Weber7, Michelle Floris-Moore8, Hector H Bolivar9, David E Vance10, Wendy J Mack11, Elizabeth T Golub12, Marcia McDonnell Holstad13, Michael T Yin14. 1. Department of Medicine, Albert Einstein College of Medicine, Bronx, NY, USA. 2. Department of Statistics and Biostatistics, Rutgers University, Piscataway, NJ, USA. 3. Department of Epidemiology and Community Health, New York Medical College, Valhalla, NY, USA. 4. Department of Medicine, State University of New York Downstate Medical Center, Brooklyn, NY, USA. 5. Department of Medicine, Georgetown University Medical Center, Washington, DC, USA. 6. Department of Medicine, San Francisco VA Medical Center, San Francisco, CA, USA. 7. Department of Medicine, John H Stroger Jr Hospital of Cook County, Chicago, IL, USA. 8. Department of Medicine, University of North Carolina School of Medicine, Chapel Hill, NC, USA. 9. Department of Medicine, University of Miami Health System, Miami, FL, USA. 10. School of Nursing, the University of Alabama at Birmingham, Birmingham, AL, USA. 11. Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA. 12. Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA. 13. Office of Academic Advancement, Emory School of Nursing, Atlanta, GA, USA. 14. Department of Medicine, Columbia University Medical Center, New York, NY, USA.
Abstract
BACKGROUND: To determine the frequency and risk factors for falls among middle-aged HIV+ and HIV- women in the Women's Interagency HIV Study (WIHS). METHODS: We quantified self-report of any and multiple (≥2) falls in the prior 6 months among 1,412 HIV+ and 650 HIV- women with mean age 48 years. Logistic regression was used to evaluate associations of demographics, behavioural factors, comorbid conditions and medications with odds of any fall (versus none) and multiple falls (versus ≤1 fall). RESULTS: At least one fall was reported in 263 HIV+ (19%) versus 119 HIV- (18%) women, and ≥2 falls reported in 133 HIV+ (9%) versus 65 HIV- (10%) women. HIV infection was not associated with falls in multivariate analyses. Factors independently associated with any fall included age (adjusted odds ratio [aOR] 1.71, 95% CI 1.17, 2.49 age 50-59 versus <39 years; aOR 2.26, 95% CI 1.38, 3.71 age ≥60 versus <39), current marijuana use (aOR 2.19, 95% CI 1.53, 3.13) depressive symptoms (aOR 1.57, 95% CI 1.21, 2.05 for Center for Epidemiology Studies Depression score ≥16), subjective cognitive complaints (aOR 2.19, 95% CI 1.56, 3.08), neuropathy (aOR 1.59, 95% CI 1.19, 2.13), obesity (aOR 1.39, 95% CI 1.08, 1.80), number of central nervous system active agents (aOR 2.98, 95% CI 1.90, 4.68 for ≥3 agents versus 0) and WIHS site. Factors associated with ≥2 falls included age, marijuana use, number of central nervous system active agents, subjective cognitive complaints, depressive symptoms, neuropathy and study site. CONCLUSIONS: Falls were associated with factors affecting cognition, but not HIV status in this large cohort of women. Longitudinal studies are needed to determine the incidence and consequences of falls by HIV status as women age.
BACKGROUND: To determine the frequency and risk factors for falls among middle-aged HIV+ and HIV- women in the Women's Interagency HIV Study (WIHS). METHODS: We quantified self-report of any and multiple (≥2) falls in the prior 6 months among 1,412 HIV+ and 650 HIV- women with mean age 48 years. Logistic regression was used to evaluate associations of demographics, behavioural factors, comorbid conditions and medications with odds of any fall (versus none) and multiple falls (versus ≤1 fall). RESULTS: At least one fall was reported in 263 HIV+ (19%) versus 119 HIV- (18%) women, and ≥2 falls reported in 133 HIV+ (9%) versus 65 HIV- (10%) women. HIV infection was not associated with falls in multivariate analyses. Factors independently associated with any fall included age (adjusted odds ratio [aOR] 1.71, 95% CI 1.17, 2.49 age 50-59 versus <39 years; aOR 2.26, 95% CI 1.38, 3.71 age ≥60 versus <39), current marijuana use (aOR 2.19, 95% CI 1.53, 3.13) depressive symptoms (aOR 1.57, 95% CI 1.21, 2.05 for Center for Epidemiology Studies Depression score ≥16), subjective cognitive complaints (aOR 2.19, 95% CI 1.56, 3.08), neuropathy (aOR 1.59, 95% CI 1.19, 2.13), obesity (aOR 1.39, 95% CI 1.08, 1.80), number of central nervous system active agents (aOR 2.98, 95% CI 1.90, 4.68 for ≥3 agents versus 0) and WIHS site. Factors associated with ≥2 falls included age, marijuana use, number of central nervous system active agents, subjective cognitive complaints, depressive symptoms, neuropathy and study site. CONCLUSIONS: Falls were associated with factors affecting cognition, but not HIV status in this large cohort of women. Longitudinal studies are needed to determine the incidence and consequences of falls by HIV status as women age.
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