TY - JOUR
T1 - Age, comorbidities, and AIDS predict a frailty phenotype in men who have sex with men
AU - Althoff, Keri N.
AU - Jacobson, Lisa P.
AU - Cranston, Ross D.
AU - Detels, Roger
AU - Phair, John P.
AU - Li, Xiuhong
AU - Margolick, Joseph B.
N1 - Funding Information:
Supplementary Material Supplementary material can be found at: http://biomedgerontology. oxfordjournals.org/ Funding Data in this manuscript were collected by the Multicenter AIDS Cohort Study (MACS) with centers at Baltimore (U01-AI35042): The Johns Hopkins University Bloomberg School of Public Health: Joseph B. Margolick (PI), Barbara Crain, Adrian Dobs, Homayoon Farzadegan, Joel Gallant, Lisette Johnson-Hill, Cynthia Munro, Michael W. Plankey, Ned Sacktor, Chloe Thio; Chicago (U01-AI35039): Feinberg School of Medicine, Northwestern University and Cook County Bureau of Health Services: Steven M. Wolinsky (PI), John P. Phair, Sheila Badri, Maurice O'Gorman, David Ostrow, Frank Palella, Ann Ragin; Los Angeles (U01-AI35040): University of California, UCLA Schools of Public Health and Medicine: Roger Detels (PI), Otoniel Martínez-Maza (Co-P I), Aaron Aronow, Robert Bolan, Elizabeth Breen, Anthony Butch, Beth Jamieson, Eric N. Miller, John Oishi, Harry Vinters, Dorothy Wiley, Mallory Witt, Otto Yang, Stephen Young, Zuo Feng Zhang; Pittsburgh (U01-AI35041): University of Pittsburgh, Graduate School of Public Health: Charles R. Rinaldo (PI), Lawrence A. Kingsley (Co-PI), James T. Becker, Ross D. Cranston, Jeremy J. Martinson, John W. Mellors, Anthony J. Silvestre, Ronald D. Stall; and the Data Coordinating Center (UM1-AI35043): The Johns Hopkins University Bloomberg School of Public Health: Lisa P. Jacobson (PI), Alvaro Munoz (Co-PI), Alison, Abraham, Keri Althoff, Christopher Cox, Jennifer Deal, Gypsyamber D’Souza, Priya Duggal, Janet Schollenberger, Eric C. Seaberg, Sol Su, Pamela Surkan. The MACS is funded primarily by the National Institute of Allergy and Infectious Diseases (NIAID), with additional co-funding from the National Cancer Institute (NCI). Targeted supplemental funding for specific projects was also provided by the National Heart, Lung, and Blood Institute (NHLBI), and the National Institute on Deafness and Communication Disorders (NIDCD). MACS data collection is also supported by UL1-TR000424 (JHU CTSA). K.N.A. was supported by K01 AI093197 from the National Institute of Allergy and Infectious Diseases.
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
AN - SCOPUS:84896743037
SN - 1079-5006
VL - 69 A
SP - 189
EP - 198
JO - Journals of Gerontology - Series A Biological Sciences and Medical Sciences
JF - Journals of Gerontology - Series A Biological Sciences and Medical Sciences
IS - 2
ER -