Frailty predicts fractures among women with and at-risk for HIV

Anjali Sharma, Qiuhu Shi, Donald R. Hoover, Phyllis C. Tien, Michael W. Plankey, Mardge H. Cohen, Elizabeth Golub, Deborah Gustafson, Michael T. Yin

Research output: Contribution to journalArticle

Abstract

OBJECTIVE: To determine associations between frailty and fracture in women with and without HIV infection. DESIGN: Prospective longitudinal cohort study evaluating associations between baseline frailty status and frailty components, with first and second incident fractures. METHODS: We evaluated associations of frailty with fracture among 1332 women with HIV and 532 uninfected women without HIV. Frailty was defined as at least three of five Fried Frailty Index components: slow gait, reduced grip strength, exhaustion, unintentional weight loss, and low physical activity. Cox proportional hazards models determined predictors of time to first and second fracture; similar models evaluated Fried Frailty Index components. RESULTS: Women with HIV were older (median 42 vs. 39 years, P < 0.0001) and more often frail (14 vs. 8%, P = 0.04) than women without HIV; median follow-up was 10.6 years. Frailty was independently associated with time to first fracture in women with and without HIV combined [adjusted hazard ratio (aHR) 1.71, 95% confidence interval (CI): 1.30-2.26; P = 0.0001], and among women with HIV only (aHR 1.91, 95% CI: 1.41-2.58; P < 0.0001), as well as with time from first to second fracture among women with HIV (aHR 1.86, 95% CI: 1.15-3.01; P = 0.01). CONCLUSION: In this cohort of middle-aged racial and ethnic minority women with or at-risk for HIV, frailty was a strong and independent predictor of fracture risk. As women with HIV continue to age, early frailty screening may be a useful clinical tool to help identify those at greatest risk of fracture.

Original languageEnglish (US)
Pages (from-to)455-463
Number of pages9
JournalAIDS (London, England)
Volume33
Issue number3
DOIs
StatePublished - Mar 1 2019

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HIV
Confidence Intervals
Hand Strength
Gait
Proportional Hazards Models
HIV Infections
Longitudinal Studies
Weight Loss
Cohort Studies
Exercise

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology
  • Infectious Diseases

Cite this

Sharma, A., Shi, Q., Hoover, D. R., Tien, P. C., Plankey, M. W., Cohen, M. H., ... Yin, M. T. (2019). Frailty predicts fractures among women with and at-risk for HIV. AIDS (London, England), 33(3), 455-463. https://doi.org/10.1097/QAD.0000000000002082

Frailty predicts fractures among women with and at-risk for HIV. / Sharma, Anjali; Shi, Qiuhu; Hoover, Donald R.; Tien, Phyllis C.; Plankey, Michael W.; Cohen, Mardge H.; Golub, Elizabeth; Gustafson, Deborah; Yin, Michael T.

In: AIDS (London, England), Vol. 33, No. 3, 01.03.2019, p. 455-463.

Research output: Contribution to journalArticle

Sharma, A, Shi, Q, Hoover, DR, Tien, PC, Plankey, MW, Cohen, MH, Golub, E, Gustafson, D & Yin, MT 2019, 'Frailty predicts fractures among women with and at-risk for HIV', AIDS (London, England), vol. 33, no. 3, pp. 455-463. https://doi.org/10.1097/QAD.0000000000002082
Sharma A, Shi Q, Hoover DR, Tien PC, Plankey MW, Cohen MH et al. Frailty predicts fractures among women with and at-risk for HIV. AIDS (London, England). 2019 Mar 1;33(3):455-463. https://doi.org/10.1097/QAD.0000000000002082
Sharma, Anjali ; Shi, Qiuhu ; Hoover, Donald R. ; Tien, Phyllis C. ; Plankey, Michael W. ; Cohen, Mardge H. ; Golub, Elizabeth ; Gustafson, Deborah ; Yin, Michael T. / Frailty predicts fractures among women with and at-risk for HIV. In: AIDS (London, England). 2019 ; Vol. 33, No. 3. pp. 455-463.
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abstract = "OBJECTIVE: To determine associations between frailty and fracture in women with and without HIV infection. DESIGN: Prospective longitudinal cohort study evaluating associations between baseline frailty status and frailty components, with first and second incident fractures. METHODS: We evaluated associations of frailty with fracture among 1332 women with HIV and 532 uninfected women without HIV. Frailty was defined as at least three of five Fried Frailty Index components: slow gait, reduced grip strength, exhaustion, unintentional weight loss, and low physical activity. Cox proportional hazards models determined predictors of time to first and second fracture; similar models evaluated Fried Frailty Index components. RESULTS: Women with HIV were older (median 42 vs. 39 years, P < 0.0001) and more often frail (14 vs. 8{\%}, P = 0.04) than women without HIV; median follow-up was 10.6 years. Frailty was independently associated with time to first fracture in women with and without HIV combined [adjusted hazard ratio (aHR) 1.71, 95{\%} confidence interval (CI): 1.30-2.26; P = 0.0001], and among women with HIV only (aHR 1.91, 95{\%} CI: 1.41-2.58; P < 0.0001), as well as with time from first to second fracture among women with HIV (aHR 1.86, 95{\%} CI: 1.15-3.01; P = 0.01). CONCLUSION: In this cohort of middle-aged racial and ethnic minority women with or at-risk for HIV, frailty was a strong and independent predictor of fracture risk. As women with HIV continue to age, early frailty screening may be a useful clinical tool to help identify those at greatest risk of fracture.",
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AU - Sharma, Anjali

AU - Shi, Qiuhu

AU - Hoover, Donald R.

AU - Tien, Phyllis C.

AU - Plankey, Michael W.

AU - Cohen, Mardge H.

AU - Golub, Elizabeth

AU - Gustafson, Deborah

AU - Yin, Michael T.

PY - 2019/3/1

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N2 - OBJECTIVE: To determine associations between frailty and fracture in women with and without HIV infection. DESIGN: Prospective longitudinal cohort study evaluating associations between baseline frailty status and frailty components, with first and second incident fractures. METHODS: We evaluated associations of frailty with fracture among 1332 women with HIV and 532 uninfected women without HIV. Frailty was defined as at least three of five Fried Frailty Index components: slow gait, reduced grip strength, exhaustion, unintentional weight loss, and low physical activity. Cox proportional hazards models determined predictors of time to first and second fracture; similar models evaluated Fried Frailty Index components. RESULTS: Women with HIV were older (median 42 vs. 39 years, P < 0.0001) and more often frail (14 vs. 8%, P = 0.04) than women without HIV; median follow-up was 10.6 years. Frailty was independently associated with time to first fracture in women with and without HIV combined [adjusted hazard ratio (aHR) 1.71, 95% confidence interval (CI): 1.30-2.26; P = 0.0001], and among women with HIV only (aHR 1.91, 95% CI: 1.41-2.58; P < 0.0001), as well as with time from first to second fracture among women with HIV (aHR 1.86, 95% CI: 1.15-3.01; P = 0.01). CONCLUSION: In this cohort of middle-aged racial and ethnic minority women with or at-risk for HIV, frailty was a strong and independent predictor of fracture risk. As women with HIV continue to age, early frailty screening may be a useful clinical tool to help identify those at greatest risk of fracture.

AB - OBJECTIVE: To determine associations between frailty and fracture in women with and without HIV infection. DESIGN: Prospective longitudinal cohort study evaluating associations between baseline frailty status and frailty components, with first and second incident fractures. METHODS: We evaluated associations of frailty with fracture among 1332 women with HIV and 532 uninfected women without HIV. Frailty was defined as at least three of five Fried Frailty Index components: slow gait, reduced grip strength, exhaustion, unintentional weight loss, and low physical activity. Cox proportional hazards models determined predictors of time to first and second fracture; similar models evaluated Fried Frailty Index components. RESULTS: Women with HIV were older (median 42 vs. 39 years, P < 0.0001) and more often frail (14 vs. 8%, P = 0.04) than women without HIV; median follow-up was 10.6 years. Frailty was independently associated with time to first fracture in women with and without HIV combined [adjusted hazard ratio (aHR) 1.71, 95% confidence interval (CI): 1.30-2.26; P = 0.0001], and among women with HIV only (aHR 1.91, 95% CI: 1.41-2.58; P < 0.0001), as well as with time from first to second fracture among women with HIV (aHR 1.86, 95% CI: 1.15-3.01; P = 0.01). CONCLUSION: In this cohort of middle-aged racial and ethnic minority women with or at-risk for HIV, frailty was a strong and independent predictor of fracture risk. As women with HIV continue to age, early frailty screening may be a useful clinical tool to help identify those at greatest risk of fracture.

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