Triin Umbleja1, Todd T Brown2, Edgar T Overton3, Heather J Ribaudo1, Jennifer A Schrack4, Kathleen V Fitch5, Pamela S Douglas6, Steven K Grinspoon5, Sarah Henn7, Roberto C Arduino8, Benigno Rodriguez9, Constance A Benson10, Kristine M Erlandson11. 1. Center for Biostatistics in AIDS Research, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA. 2. Johns Hopkins University School of Medicine, Baltimore, Maryland, USA. 3. University of Alabama at Birmingham School of Medicine, Birmingham, Alabama, USA. 4. Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA. 5. Metabolism Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA. 6. Duke Clinical Research Institute, Duke University Medical Center, Durham, North Carolina, USA. 7. Whitman Walker Health, Washington, DC, USA. 8. McGovern Medical School at UTHealth, Houston, Texas, USA. 9. Case Western Reserve University, Cleveland, Ohio, USA. 10. University of California, San Diego, California, USA. 11. University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA.
Abstract
BACKGROUND:People with human immunodeficiency virus (PWH) are at risk for accelerated development of physical function impairment and frailty; both associated with increased risk of falls, hospitalizations, and death. Identifying factors associated with physical function impairment and frailty can help target interventions. METHODS: The REPRIEVE trial enrolled participants 40-75 years of age, receiving stable antiretroviral therapy with CD4+ T-cell count >100 cells/mm3, and with low to moderate cardiovascular disease risk. We conducted a cross-sectional analysis of those concurrently enrolled in the ancillary study PREPARE at enrollment. RESULTS: Among the 266 participants, the median age was 51 years; 81% were male, and 45% were black, and 28% had hypertension. Body mass index (BMI; calculated as weight in kilograms divided by height in meters squared) was 25 to <30 in 38% and ≥30 in 30%, 33% had a high waist circumference, 89% were physically inactive, 37% (95% confidence interval, 31%, 43%) had physical function impairment (Short Physical Performance Battery score ≤10), and 6% (4%, 9%) were frail and 42% prefrail. In the adjusted analyses, older age, black race, greater BMI, and physical inactivity were associated with physical function impairment; depression and hypertension were associated with frailty or prefrailty. CONCLUSIONS:Physical function impairment was common among middle-aged PWH; greater BMI and physical inactivity are important modifiable factors that may prevent further decline in physical function with aging. CLINICAL TRIALS REGISTRATION: NCT02344290.
RCT Entities:
BACKGROUND:People with human immunodeficiency virus (PWH) are at risk for accelerated development of physical function impairment and frailty; both associated with increased risk of falls, hospitalizations, and death. Identifying factors associated with physical function impairment and frailty can help target interventions. METHODS: The REPRIEVE trial enrolled participants 40-75 years of age, receiving stable antiretroviral therapy with CD4+ T-cell count >100 cells/mm3, and with low to moderate cardiovascular disease risk. We conducted a cross-sectional analysis of those concurrently enrolled in the ancillary study PREPARE at enrollment. RESULTS: Among the 266 participants, the median age was 51 years; 81% were male, and 45% were black, and 28% had hypertension. Body mass index (BMI; calculated as weight in kilograms divided by height in meters squared) was 25 to <30 in 38% and ≥30 in 30%, 33% had a high waist circumference, 89% were physically inactive, 37% (95% confidence interval, 31%, 43%) had physical function impairment (Short Physical Performance Battery score ≤10), and 6% (4%, 9%) were frail and 42% prefrail. In the adjusted analyses, older age, black race, greater BMI, and physical inactivity were associated with physical function impairment; depression and hypertension were associated with frailty or prefrailty. CONCLUSIONS: Physical function impairment was common among middle-aged PWH; greater BMI and physical inactivity are important modifiable factors that may prevent further decline in physical function with aging. CLINICAL TRIALS REGISTRATION: NCT02344290.
Authors: Udo Hoffmann; Michael T Lu; Devvora Olalere; Elizabeth C Adami; Michael T Osborne; Alex Ivanov; John Sukumar Aluru; Saeyun Lee; Nadja Arifovic; Edgar Turner Overton; Carl J Fichtenbaum; Judith A Aberg; Beverly Alston-Smith; Karin L Klingman; Myron Waclawiw; Tricia H Burdo; Kenneth C Williams; Markella V Zanni; Patrice Desvigne-Nickens; Katharine Cooper-Arnold; Kathleen V Fitch; Heather Ribaudo; Pamela S Douglas; Steven K Grinspoon Journal: Am Heart J Date: 2019-03-04 Impact factor: 4.749
Authors: Jessica L Montoya; Catherine M Jankowski; Kelly K O'Brien; Allison R Webel; Krisann K Oursler; Brook L Henry; David J Moore; Kristine M Erlandson Journal: AIDS Date: 2019-05-01 Impact factor: 4.177
Authors: Patrick W G Mallon; John Miller; Jason C Kovacic; Julia Kent-Hughes; Richard Norris; Katherine Samaras; Michael P Feneley; David A Cooper; Andrew Carr Journal: AIDS Date: 2006-04-24 Impact factor: 4.177
Authors: Meredith Greene; Kenneth Covinsky; Jacquie Astemborski; Damani A Piggott; Todd Brown; Sean Leng; Noya Galai; Shruti H Mehta; Jack Guralnik; Kushang V Patel; Gregory D Kirk Journal: AIDS Date: 2014-11-28 Impact factor: 4.177
Authors: David S H Lee; Sheila Markwardt; Leah Goeres; Christine G Lee; Elizabeth Eckstrom; Craig Williams; Rongwei Fu; Eric Orwoll; Peggy M Cawthon; Marcia L Stefanick; Dawn Mackey; Douglas C Bauer; Carrie M Nielson Journal: JAMA Intern Med Date: 2014-08 Impact factor: 21.873
Authors: Kristine M Erlandson; Kathleen V Fitch; Sara A McCallum; Heather J Ribaudo; Edgar T Overton; Markella V Zanni; Gerald S Bloomfield; Todd T Brown; Carl J Fichtenbaum; Sara Bares; Judith A Aberg; Pamela S Douglas; Evelynne S Fulda; Jorge L Santana-Bagur; Jose G Castro; Laura E Moran; Vidya Mave; Khuanchai Supparatpinyo; Ponego L Ponatshego; Mauro Schechter; Steven K Grinspoon Journal: Clin Infect Dis Date: 2022-09-30 Impact factor: 20.999
Authors: Mark H Kuniholm; Elizabeth Vásquez; Allison A Appleton; Lawrence Kingsley; Frank J Palella; Matthew Budoff; Erin D Michos; Ervin Fox; Deborah Jones; Adaora A Adimora; Igho Ofotokun; Gypsyamber D'souza; Kathleen M Weber; Phyllis C Tien; Michael Plankey; Anjali Sharma; Deborah R Gustafson Journal: AIDS Date: 2022-02-01 Impact factor: 4.632
Authors: Stephanie M Dillon; Mona H Abdo; Melissa P Wilson; Jay Liu; Catherine M Jankowski; Charles E Robertson; Yunus Tuncil; Bruce Hamaker; Daniel N Frank; Samantha MaWhinney; Cara C Wilson; Kristine M Erlandson Journal: AIDS Res Hum Retroviruses Date: 2021-04-30 Impact factor: 1.723
Authors: David R Lorenz; Shibani S Mukerji; Vikas Misra; Hajime Uno; Benjamin B Gelman; David J Moore; Elyse J Singer; Susan Morgello; Dana Gabuzda Journal: AIDS Date: 2021-12-01 Impact factor: 4.177