Age, comorbidities, and AIDS predict a frailty phenotype in men who have sex with men

Keri Althoff, Lisa Paula Jacobson, Ross D. Cranston, Roger Detels, John P. Phair, Xiuhong Li, Joseph Bernard Margolick

Research output: Contribution to journalArticle

Abstract

Background. Adults aging with HIV infection are at risk for age-related comorbidities and syndromes, such as frailty. The objective of this study was to evaluate the expression and predictors of the frailty phenotype (FP) among HIV-infected (HIV+) and HIV-uninfected (HIV-) men who have sex with men. Methods. A prospective, observational cohort study was nested in the Multicenter AIDS Cohort Study from October 2007-September 2011. FP conversion was defned as the onset of FP over two consecutive study visits. Adjusted odds ratios and 95% confdence intervals ([,]) for FP conversion were estimated using logistic regression models with generalized estimating equations. Results. Of 10,571 completed study visits from 1,946 men who have sex with men, 12% and 9% were FP+ among HIV+ and HIV-men, respectively (p =.002). The proportion of FP+ visits increased with age regardless of HIV status, but was significantly greater in HIV+ compared to HIV-men aged 50-64 years. Of the 10,276 consecutive visit pairs contributed by participants, 5% (537) were classifed as FP conversion, and 45% of the men with FP conversion had only one FP+ study visit. FP conversion was significantly associated with a history of AIDS (adjusted odds ratios = 2.26 [1.50, 3.39], but not with HIV+ alone (adjusted odds ratios = 1.26 [0.98, 1.64]). Among men who had one or more FP+ visits, 34% of HIV+ and 38% of HIV-men had less than two comorbidities. Conclusions. These fndings suggest that expression of the FP can be measured in men who have sex with men with and without HIV infection and refects multisystem dysfunction in this population; further investigations are needed to better understand clinical utility.

Original languageEnglish (US)
Pages (from-to)189-198
Number of pages10
JournalJournals of Gerontology - Series A Biological Sciences and Medical Sciences
Volume69 A
Issue number2
DOIs
StatePublished - 2014

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Comorbidity
Acquired Immunodeficiency Syndrome
HIV
Phenotype
Odds Ratio
HIV Infections
Cohort Studies
Logistic Models
Observational Studies

Keywords

  • Epidemiology
  • Frailty
  • Multimorbidities

ASJC Scopus subject areas

  • Aging
  • Geriatrics and Gerontology
  • Medicine(all)

Cite this

@article{81c47bae2dd04557b4eb4fabaf66c7a9,
title = "Age, comorbidities, and AIDS predict a frailty phenotype in men who have sex with men",
abstract = "Background. Adults aging with HIV infection are at risk for age-related comorbidities and syndromes, such as frailty. The objective of this study was to evaluate the expression and predictors of the frailty phenotype (FP) among HIV-infected (HIV+) and HIV-uninfected (HIV-) men who have sex with men. Methods. A prospective, observational cohort study was nested in the Multicenter AIDS Cohort Study from October 2007-September 2011. FP conversion was defned as the onset of FP over two consecutive study visits. Adjusted odds ratios and 95{\%} confdence intervals ([,]) for FP conversion were estimated using logistic regression models with generalized estimating equations. Results. Of 10,571 completed study visits from 1,946 men who have sex with men, 12{\%} and 9{\%} were FP+ among HIV+ and HIV-men, respectively (p =.002). The proportion of FP+ visits increased with age regardless of HIV status, but was significantly greater in HIV+ compared to HIV-men aged 50-64 years. Of the 10,276 consecutive visit pairs contributed by participants, 5{\%} (537) were classifed as FP conversion, and 45{\%} of the men with FP conversion had only one FP+ study visit. FP conversion was significantly associated with a history of AIDS (adjusted odds ratios = 2.26 [1.50, 3.39], but not with HIV+ alone (adjusted odds ratios = 1.26 [0.98, 1.64]). Among men who had one or more FP+ visits, 34{\%} of HIV+ and 38{\%} of HIV-men had less than two comorbidities. Conclusions. These fndings suggest that expression of the FP can be measured in men who have sex with men with and without HIV infection and refects multisystem dysfunction in this population; further investigations are needed to better understand clinical utility.",
keywords = "Epidemiology, Frailty, Multimorbidities",
author = "Keri Althoff and Jacobson, {Lisa Paula} and Cranston, {Ross D.} and Roger Detels and Phair, {John P.} and Xiuhong Li and Margolick, {Joseph Bernard}",
year = "2014",
doi = "10.1093/gerona/glt148",
language = "English (US)",
volume = "69 A",
pages = "189--198",
journal = "Journals of Gerontology - Series A Biological Sciences and Medical Sciences",
issn = "1079-5006",
publisher = "Oxford University Press",
number = "2",

}

TY - JOUR

T1 - Age, comorbidities, and AIDS predict a frailty phenotype in men who have sex with men

AU - Althoff, Keri

AU - Jacobson, Lisa Paula

AU - Cranston, Ross D.

AU - Detels, Roger

AU - Phair, John P.

AU - Li, Xiuhong

AU - Margolick, Joseph Bernard

PY - 2014

Y1 - 2014

N2 - Background. Adults aging with HIV infection are at risk for age-related comorbidities and syndromes, such as frailty. The objective of this study was to evaluate the expression and predictors of the frailty phenotype (FP) among HIV-infected (HIV+) and HIV-uninfected (HIV-) men who have sex with men. Methods. A prospective, observational cohort study was nested in the Multicenter AIDS Cohort Study from October 2007-September 2011. FP conversion was defned as the onset of FP over two consecutive study visits. Adjusted odds ratios and 95% confdence intervals ([,]) for FP conversion were estimated using logistic regression models with generalized estimating equations. Results. Of 10,571 completed study visits from 1,946 men who have sex with men, 12% and 9% were FP+ among HIV+ and HIV-men, respectively (p =.002). The proportion of FP+ visits increased with age regardless of HIV status, but was significantly greater in HIV+ compared to HIV-men aged 50-64 years. Of the 10,276 consecutive visit pairs contributed by participants, 5% (537) were classifed as FP conversion, and 45% of the men with FP conversion had only one FP+ study visit. FP conversion was significantly associated with a history of AIDS (adjusted odds ratios = 2.26 [1.50, 3.39], but not with HIV+ alone (adjusted odds ratios = 1.26 [0.98, 1.64]). Among men who had one or more FP+ visits, 34% of HIV+ and 38% of HIV-men had less than two comorbidities. Conclusions. These fndings suggest that expression of the FP can be measured in men who have sex with men with and without HIV infection and refects multisystem dysfunction in this population; further investigations are needed to better understand clinical utility.

AB - Background. Adults aging with HIV infection are at risk for age-related comorbidities and syndromes, such as frailty. The objective of this study was to evaluate the expression and predictors of the frailty phenotype (FP) among HIV-infected (HIV+) and HIV-uninfected (HIV-) men who have sex with men. Methods. A prospective, observational cohort study was nested in the Multicenter AIDS Cohort Study from October 2007-September 2011. FP conversion was defned as the onset of FP over two consecutive study visits. Adjusted odds ratios and 95% confdence intervals ([,]) for FP conversion were estimated using logistic regression models with generalized estimating equations. Results. Of 10,571 completed study visits from 1,946 men who have sex with men, 12% and 9% were FP+ among HIV+ and HIV-men, respectively (p =.002). The proportion of FP+ visits increased with age regardless of HIV status, but was significantly greater in HIV+ compared to HIV-men aged 50-64 years. Of the 10,276 consecutive visit pairs contributed by participants, 5% (537) were classifed as FP conversion, and 45% of the men with FP conversion had only one FP+ study visit. FP conversion was significantly associated with a history of AIDS (adjusted odds ratios = 2.26 [1.50, 3.39], but not with HIV+ alone (adjusted odds ratios = 1.26 [0.98, 1.64]). Among men who had one or more FP+ visits, 34% of HIV+ and 38% of HIV-men had less than two comorbidities. Conclusions. These fndings suggest that expression of the FP can be measured in men who have sex with men with and without HIV infection and refects multisystem dysfunction in this population; further investigations are needed to better understand clinical utility.

KW - Epidemiology

KW - Frailty

KW - Multimorbidities

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U2 - 10.1093/gerona/glt148

DO - 10.1093/gerona/glt148

M3 - Article

C2 - 24127428

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VL - 69 A

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JO - Journals of Gerontology - Series A Biological Sciences and Medical Sciences

JF - Journals of Gerontology - Series A Biological Sciences and Medical Sciences

SN - 1079-5006

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