Howell T Jones1,2, Tom Levett3,4, Tristan J Barber1,5. 1. Royal Free Hospital, Royal Free London NHS Foundation Trust, London, UK. 2. MRC Unit for Lifelong Health and Ageing at UCL, London, UK. 3. Royal Sussex County Hospital, University Hospitals Sussex NHS Foundation Trust, Brighton, UK. 4. Department of Clinical and Experimental Medicine, Brighton and Sussex Medical School, Falmer, Brighton, UK. 5. Institute for Global Health, UCL, London, Institute of Child Health, London, UK.
Abstract
PURPOSE OF REVIEW: The HIV population is ageing with rising rates of frailty though strategies of how best to manage it remain ill-defined. It also remains unclear what the prevalence of frailty is within this cohort, how best to diagnose it and what factors are associated. RECENT FINDINGS: The prevalence of frailty remains unclear because of heterogenous results. Routine screening in those 50+ is recommended and whilst the Fried Frailty Phenotype is currently preferred the Clinical Frailty Scale could be considered. No biomarkers are currently recommended. Looking at associated factors, HIV neurocognitive impairment and long-term alcohol usage has been shown to be associated with developing frailty whilst those who are frail have been shown to be less active and more likely to fall. NAFLD with fibrosis has been shown to be an indicator of metabolic age and the Pooled Cohort Equations has been shown to be more effective in diagnosing cardiovascular risk in frail people living with HIV. SUMMARY: Whilst the prevalence of frailty differs between countries, with the addition of prefrailty, this represents a large proportion of people living with HIV. Services must ensure strategies are in place to support those living with HIV and frailty. Further longitudinal studies are required.
PURPOSE OF REVIEW: The HIV population is ageing with rising rates of frailty though strategies of how best to manage it remain ill-defined. It also remains unclear what the prevalence of frailty is within this cohort, how best to diagnose it and what factors are associated. RECENT FINDINGS: The prevalence of frailty remains unclear because of heterogenous results. Routine screening in those 50+ is recommended and whilst the Fried Frailty Phenotype is currently preferred the Clinical Frailty Scale could be considered. No biomarkers are currently recommended. Looking at associated factors, HIV neurocognitive impairment and long-term alcohol usage has been shown to be associated with developing frailty whilst those who are frail have been shown to be less active and more likely to fall. NAFLD with fibrosis has been shown to be an indicator of metabolic age and the Pooled Cohort Equations has been shown to be more effective in diagnosing cardiovascular risk in frail people living with HIV. SUMMARY: Whilst the prevalence of frailty differs between countries, with the addition of prefrailty, this represents a large proportion of people living with HIV. Services must ensure strategies are in place to support those living with HIV and frailty. Further longitudinal studies are required.
Authors: Jennifer L Thompson; David P Sheppard; Anastasia Matchanova; Erin E Morgan; Shayne Loft; Steven Paul Woods Journal: Neuropsychol Dev Cogn B Aging Neuropsychol Cogn Date: 2022-04-12