Frailty among HIV-infected persons in an urban outpatient care setting.
OBJECTIVE
Frailty among HIV-infected persons is increasingly recognized but data are limited. We aimed to determine frailty prevalence, predictors and clinical significance in this population.


METHODS
This was a prospective cross-sectional study of HIV-infected persons > or =18 years attending Washington University HIV Clinics between June and December 2008. Frailty was defined by > or =3 of 5 criteria: weight loss, low physical activity, exhaustion, weak grip strength and slow walking time. Independent predictors of frailty were evaluated using multivariate logistic regression analyses.


RESULTS
445 persons were studied; mean age 41.7 years, 71% male, 63% African American with a mean 8.4 years since HIV diagnosis. 75% were on antiretroviral therapy with median CD4+437 cells/mm(3). Frailty prevalence was 9%. Independent predictors of frailty included unemployment, greater number of comorbid conditions and past opportunistic illnesses, higher depression severity score, receipt of antidepressants and lower serum albumin. Hospitalization rates were greater for frail persons with a five-fold longer duration of inpatient stay.


CONCLUSIONS
HIV infection was associated with a premature presentation of frailty. Frailty was associated with greater comorbidity, markers of advanced immunodeficiency and adverse socioeconomic and clinical outcomes. Further study of frailty in patients with HIV infection is warranted.
Onen
Nur F
NF
Department of Infectious Diseases, Washington University School of Medicine, 660 S. Euclid Avenue, St. Louis, MO 63110, USA. nonen@dom.wustl.edu
Agbebi
Abayomi
A
Shacham
Enbal
E
Stamm
Kate E
KE
Onen
Alev R
AR
Overton
E Turner
ET
D000328:Adult; D001741:Black or African American; D000553:Ambulatory Care; D015897:Comorbidity; D003710:Demography; D005260:Female; D015658:HIV Infections / Q000453:epidemiology* / Q000208:ethnology; D006630:Hispanic or Latino; D006786:Hospitals, Urban; D006801:Humans; D015994:Incidence; D008297:Male; D018908:Muscle Weakness / Q000453:epidemiology* / Q000208:ethnology; D015431:Weight Loss; D044465:White People