Disability Among Middle-Aged and Older Persons With Human Immunodeficiency Virus Infection.

Autor/Urheber	Johs, Nikolas A; Wu, Kunling; Tassiopoulos, Katherine; Koletar, Susan L; Kalayjian, Robert C; Ellis, Ronald J; Taiwo, Babafemi; Jr, Palella Frank J; Erlandson, Kristine M
Institution	eScholarship, University of California
Titel	Disability Among Middle-Aged and Older Persons With Human Immunodeficiency Virus Infection.
Quelle	In: qt0g18q3cv; Johs, Nikolas A; Wu, Kunling; Tassiopoulos, Katherine; Koletar, Susan L; Kalayjian, Robert C; Ellis, Ronald J; et al.(2017). Disability Among Middle-Aged and Older Persons With Human Immunodeficiency Virus Infection. CLINICAL INFECTIOUS DISEASES, 65(1), 83 - 91. doi:10.1093/cid/cix253. UC San Diego: Retrieved from: http://www.escholarship.org/uc/item/0g18q3cv(2017) PDF als Volltext kostenfreie Datei
Sprache	englisch
Dokumenttyp	online; Zeitschriftenaufsatz
Schlagwörter	HIV; disability; neurocognitive impairment; physical activity; frailty; Humans; HIV Infections; Cross-Sectional Studies; Comorbidity; Adult; Aged; Middle Aged; Female; Male; Biological Sciences; Medical And Health Sciences; Microbiology
Abstract	Older human immunodeficiency virus (HIV)-infected adults may experience higher rates of frailty and disability than the general population. Improved understanding of the prevalence, risk factors, and types of impairment can better inform providers and the healthcare system.HIV-infected participants within the AIDS Clinical Trials Group A5322 HAILO study self-reported disability by the Lawton-Brody Instrumental Activities of Daily Living (IADL) Questionnaire. Frailty was measured by 4-m walk time, grip strength, self-reported weight loss, exhaustion, and low activity. Logistic regression models identified characteristics associated with any IADL impairment. Agreement between IADL impairment and frailty was assessed using the weighted kappa statistic.Of 1015 participants, the median age was 51 years, 15 were aged ≥60 years, 19 were female, 29 black, and 20 Hispanic. At least 1 IADL impairment was reported in 18 of participants, most commonly with housekeeping (48) and transportation (36) and least commonly with medication management (5). In multivariable models, greater disability was significantly associated with neurocognitive impairment, lower education, Medicare/Medicaid insurance (vs private/other coverage), smoking, and low physical activity. Although a greater proportion of frail participants had IADL impairment (52) compared to non-frail (11) persons, agreement was poor (weighted kappa <0.18, 95 confidence interval, 0.13, 0.23).IADL disability occurs frequently among middle-aged and older HIV-infected adults on effective antiretroviral therapy. Potentially modifiable risk factors (smoking, physical activity) provide targets for interventions to maintain independent living. Systematic recognition of persons at greater risk for disability can facilitate connection to resources that may help preserve independence.
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