Anjali Sharma1, Donald R Hoover2, Qiuhu Shi3, Deborah R Gustafson4, Michael W Plankey5, Phyllis C Tien6,7, Kathleen M Weber8, Michael T Yin9. 1. Department of Medicine, Albert Einstein College of Medicine, Bronx, NY, USA. 2. Department of Statistics and Biostatistics, Rutgers University, New Brunswick, NJ, USA. 3. School of Health Sciences and Practice, New York Medical College, Valhalla, NY, USA. 4. Department of Neurology, 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, University of California San Francisco, San Francisco, CA, USA. 8. Cook County Health and Hospitals System/Hektoen Institute of Medicine, Chicago, IL, USA. 9. Department of Medicine, College of Physicians and Surgeons, Columbia University Medical Center, New York, NY, USA.
Abstract
BACKGROUND: Frailty and falls occur commonly and prematurely in HIV-infected populations. Whether frailty in middle-age predicts future falls among HIV-infected women is unknown. METHODS: We evaluated associations of frailty with single and recurrent falls 10 years later among 729 HIV-infected and 326 uninfected women in the Women's Interagency HIV Study (WIHS) with frailty measured in 2005 and self-reported falls in 2014-2016. Frailty was defined as ≥3 of 5 Fried Frailty Index components: slow gait, reduced grip strength, exhaustion, unintentional weight loss and low physical activity. Stepwise logistic regression models determined odds of single (versus 0) or recurrent falls (≥2 versus 0) during the 2-year period; separate models evaluated frailty components. RESULTS: HIV-infected women were older (median 42 versus 39 years; P<0.0001) and more often frail (14% versus 9%; P=0.04) than uninfected women. Over 2 years, 40% of HIV-infected versus 39% of uninfected women reported a fall (single fall in 15% HIV+ versus 18% HIV- women; recurrent falls in 25% HIV+ versus 20% HIV- women [overall P=0.20]). In multivariate models, frailty independently predicted recurrent falls (adjusted odds ratio [aOR] 1.84, 95% CI: 1.13, 2.97; P=0.01), but not a single fall. Among frailty components, unintentional weight loss independently predicted single fall (aOR 2.31, 95% CI: 1.28, 4.17; P=0.005); unintentional weight loss (aOR 2.26, 95% CI: 1.32, 3.86; P=0.003) and exhaustion (aOR 1.66, 95% CI: 1.10, 2.50; P=0.02) independently predicted recurrent falls. CONCLUSIONS: Early frailty measurement among middle-aged women with or at-risk for HIV may be a useful tool to assess future fall risk.
BACKGROUND: Frailty and falls occur commonly and prematurely in HIV-infected populations. Whether frailty in middle-age predicts future falls among HIV-infectedwomen is unknown. METHODS: We evaluated associations of frailty with single and recurrent falls 10 years later among 729 HIV-infected and 326 uninfected women in the Women's Interagency HIV Study (WIHS) with frailty measured in 2005 and self-reported falls in 2014-2016. Frailty was defined as ≥3 of 5 Fried Frailty Index components: slow gait, reduced grip strength, exhaustion, unintentional weight loss and low physical activity. Stepwise logistic regression models determined odds of single (versus 0) or recurrent falls (≥2 versus 0) during the 2-year period; separate models evaluated frailty components. RESULTS:HIV-infectedwomen were older (median 42 versus 39 years; P<0.0001) and more often frail (14% versus 9%; P=0.04) than uninfected women. Over 2 years, 40% of HIV-infected versus 39% of uninfected women reported a fall (single fall in 15% HIV+ versus 18% HIV- women; recurrent falls in 25% HIV+ versus 20% HIV- women [overall P=0.20]). In multivariate models, frailty independently predicted recurrent falls (adjusted odds ratio [aOR] 1.84, 95% CI: 1.13, 2.97; P=0.01), but not a single fall. Among frailty components, unintentional weight loss independently predicted single fall (aOR 2.31, 95% CI: 1.28, 4.17; P=0.005); unintentional weight loss (aOR 2.26, 95% CI: 1.32, 3.86; P=0.003) and exhaustion (aOR 1.66, 95% CI: 1.10, 2.50; P=0.02) independently predicted recurrent falls. CONCLUSIONS: Early frailty measurement among middle-aged women with or at-risk for HIV may be a useful tool to assess future fall risk.
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