PMID- 29788039
OWN - NLM
STAT- MEDLINE
DCOM- 20200120
LR  - 20210514
IS  - 1537-6591 (Electronic)
IS  - 1058-4838 (Print)
IS  - 1058-4838 (Linking)
VI  - 68
IP  - 1
DP  - 2019 Jan 1
TI  - Frailty, Neurocognitive Impairment, or Both in Predicting Poor Health Outcomes 
      Among Adults Living With Human Immunodeficiency Virus.
PG  - 131-138
LID - 10.1093/cid/ciy430 [doi]
AB  - BACKGROUND: Neurocognitive impairment (NCI) is strongly associated with frailty 
      in people living with human immunodeficiency virus (PLWH); the overlap of frailty 
      and NCI and the impact on health outcomes in PLWH are unknown. METHODS: PLWH in a 
      longitudinal, observational study of aging completed entry evaluations for 
      frailty and NCI. Outcomes of falls (recurrent) increased limitations in 
      independent activities of daily living (IADL), or mortality were combined. 
      Poisson regression models estimated prevalence ratios (PR) for >/=1 outcome over 2 
      years. RESULTS: Among 987 participants, the median age at entry was 51 years; 19% 
      were female; the median CD4 count was 616 cells/microL; and HIV-1 RNA was <200 
      copies/mL in 94%. Most (79%) participants had neither frailty nor NCI; 2% had 
      both; 4% frailty only; and 15% NCI only. Over 2 years of observation, 100 (10%) 
      participants experienced recurrent falls; 175 (18%) had worsening IADL 
      limitations; 17 (2%) died; and 254 (26%) experienced >/=1 poor health outcome. In 
      adjusted models, frailty with NCI was associated with more than double the risk 
      of a poor health outcome (PR 2.65; 95% CI 1.98, 3.54); a significant association 
      was also seen with frailty alone (PR 2.26; 95%CI 1.71, 2.99) and NCI alone (PR 
      1.73; 95% CI 1.36, 2.20). CONCLUSIONS: The presence of frailty with NCI was 
      associated with a greater risk of falls, disability, or death in PLWH than NCI 
      alone. Interventions that target prevention or reversal of both frailty and NCI 
      (such as increased physical activity) may significantly limit poor health 
      outcomes among PLWH.
FAU - Erlandson, Kristine M
AU  - Erlandson KM
AD  - Department of Medicine, Division of Infectious Diseases, University of 
      Colorado-Anschutz Medical Campus, Aurora.
FAU - Perez, Jeremiah
AU  - Perez J
AD  - Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
FAU - Abdo, Mona
AU  - Abdo M
AD  - Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
FAU - Robertson, Kevin
AU  - Robertson K
AD  - Department of Neurology, University of North Carolina-Chapel Hill.
FAU - Ellis, Ronald J
AU  - Ellis RJ
AD  - Department of Neurosciences, University of California San Diego.
FAU - Koletar, Susan L
AU  - Koletar SL
AD  - Department of Internal Medicine, Ohio State University, Columbus.
FAU - Kalayjian, Robert
AU  - Kalayjian R
AD  - MetroHealth and Louis Stokes Cleveland Veterans Administration Medical Center, 
      Department of Medicine, Ohio.
FAU - Taiwo, Babafemi
AU  - Taiwo B
AD  - Northwestern University Feinberg School of Medicine, Department of Medicine, 
      Chicago, Illinois.
FAU - Palella, Frank J Jr
AU  - Palella FJ Jr
AD  - Northwestern University Feinberg School of Medicine, Department of Medicine, 
      Chicago, Illinois.
FAU - Tassiopoulos, Katherine
AU  - Tassiopoulos K
AD  - Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
LA  - eng
GR  - UM1 AI069432/AI/NIAID NIH HHS/United States
GR  - K23 AG050260/AG/NIA NIH HHS/United States
GR  - UM1 AI069471/AI/NIAID NIH HHS/United States
GR  - R01 AG054366/AG/NIA NIH HHS/United States
GR  - UM1 AI068634/AI/NIAID NIH HHS/United States
GR  - UM1 AI069494/AI/NIAID NIH HHS/United States
GR  - UM1 AI069423/AI/NIAID NIH HHS/United States
GR  - U01 AI068634/AI/NIAID NIH HHS/United States
GR  - UM1 AI068636/AI/NIAID NIH HHS/United States
PT  - Journal Article
PT  - Observational Study
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, U.S. Gov't, Non-P.H.S.
PL  - United States
TA  - Clin Infect Dis
JT  - Clinical infectious diseases : an official publication of the Infectious Diseases 
      Society of America
JID - 9203213
SB  - IM
MH  - Adult
MH  - *Clinical Decision Rules
MH  - Cognitive Dysfunction/complications/*diagnosis/*pathology
MH  - Frailty/complications/*diagnosis/*pathology
MH  - HIV Infections/complications/*diagnosis/*pathology
MH  - Humans
MH  - Longitudinal Studies
MH  - Male
MH  - Middle Aged
MH  - Prognosis
PMC - PMC6293002
EDAT- 2018/05/23 06:00
MHDA- 2020/01/21 06:00
PMCR- 2019/05/18
CRDT- 2018/05/23 06:00
PHST- 2018/03/16 00:00 [received]
PHST- 2018/05/14 00:00 [accepted]
PHST- 2018/05/23 06:00 [pubmed]
PHST- 2020/01/21 06:00 [medline]
PHST- 2018/05/23 06:00 [entrez]
PHST- 2019/05/18 00:00 [pmc-release]
AID - 4999314 [pii]
AID - ciy430 [pii]
AID - 10.1093/cid/ciy430 [doi]
PST - ppublish
SO  - Clin Infect Dis. 2019 Jan 1;68(1):131-138. doi: 10.1093/cid/ciy430.