Longitudinal study of falls among HIV-infected and uninfected women: The role of cognition

Background: Although fracture rates are higher in HIV+ HIV- women, including ≥2 falls in 25% HIV+ and 24% HIV-than HIV- women, whether HIV infection increases risk (overall P=0.30). Cognitive complaints were associated of falls is unclear. We determined the longitudinal occur-with falls among HIV+ (odds ratio [OR] 2.38; 95% CI 1.83, rence and risk factors for falls in the Women’s Intera-3.09) and HIV- women (OR 3.43; 95% CI 2.37, 4.97); in gency HIV Study (WIHS), and explored associations with adjusted models, cognitive complaints remained significant cognitive complaints. only in HIV- women (adjusted [aOR] 2.26; 95% CI 1.46, Methods: Recent (prior 6 months) self-reported falls were 3.48). Factors associated with any fall in adjusted analyses collected in 1,816 (1,250 HIV+; 566 HIV-) women over included: depressive symptoms and neuropathy (both HIV+ 24 months. Generalized estimating equation models using and HIV-); age, marijuana use, multiple CNS medications, stepwise selection determined odds of any fall (versus and HCV infection (HIV+ only); and cognitive complaints, none). quality of life, hypertension and obesity (HIV- only). Results: HIV+ women were older than HIV- women Conclusions: Middle-aged HIV+ and HIV- women had (median 49 versus 47 years; P=0.0004), more likely to similar fall rates. Among HIV+ women, factors affecting report neuropathy (20% versus 16%; P=0.023), and had cognition such as age, depressive symptoms, marijuana greater central nervous system (CNS) medication use. use and multiple CNS medications were important predic-At least one fall was reported in 41% HIV+ versus 42% tors of falls, however, cognitive complaints were not.