title: Association of age and comorbidity with physical function in HIV-infected and uninfected patients: results from the Veterans Aging Cohort Study.
abstract: HIV clinical care now involves prevention and treatment of age-associated comorbidity. Although physical function is an established correlate to comorbidity in older adults without HIV infection, its role in aging of HIV-infected adults is not well understood. To investigate this question we conducted cross-sectional analyses including linear regression models of physical function in 3227 HIV-infected and 3240 uninfected patients enrolled 2002-2006 in the Veterans Aging Cohort Study-8-site (VACS-8). Baseline self-reported physical function correlated with the Short Form-12 physical subscale (ρ = 0.74, p < 0.001), and predicted survival. Across the age groups decline in physical function per year was greater in HIV-infected patients (β(coef) -0.25, p < 0.001) compared to uninfected patients (β(coef) -0.08, p = 0.03). This difference, although statistically significant (p < 0.01), was small. Function in the average 50-year old HIV-infected subject was equivalent to the average 51.5-year-old uninfected subject. History of cardiovascular disease was a significant predictor of poor function, but the effect was similar across groups. Chronic pulmonary disease had a differential effect on function by HIV status (Δβ(coef) -3.5, p = 0.03). A 50-year-old HIV-infected subject with chronic pulmonary disease had the equivalent level of function as a 68.1-year-old uninfected subject with chronic pulmonary disease. We conclude that age-associated comorbidity affects physical function in HIV-infected patients, and may modify the effect of aging. Longitudinal research with markers of disease severity is needed to investigate loss of physical function with aging, and to develop age-specific HIV care guidelines.
authors.affiliation: Departement of Medicine, University of Maryland School of Medicine, Veterans Affairs Maryland Healthcare System, Baltimore, Maryland 21201-1524, USA. koursler@grecc.umaryland.edu
authors.forename: Krisann K
authors.initials: KK
authors.lastname: Oursler
authors.forename: Joseph L
authors.initials: JL
authors.lastname: Goulet
authors.forename: Stephen
authors.initials: S
authors.lastname: Crystal
authors.forename: Amy C
authors.initials: AC
authors.lastname: Justice
authors.forename: Kristina
authors.initials: K
authors.lastname: Crothers
authors.forename: Adeel A
authors.initials: AA
authors.lastname: Butt
authors.forename: Maria C
authors.initials: MC
authors.lastname: Rodriguez-Barradas
authors.forename: Knachelle
authors.initials: K
authors.lastname: Favors
authors.forename: David
authors.initials: D
authors.lastname: Leaf
authors.forename: Leslie I
authors.initials: LI
authors.lastname: Katzel
authors.forename: John D
authors.initials: JD
authors.lastname: Sorkin
mesh_terms: D000328:Adult; D000375:Aging; D015331:Cohort Studies; D015897:Comorbidity; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000453:epidemiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009043:Motor Activity / Q000502:physiology*; D012307:Risk Factors; D014481:United States / Q000453:epidemiology; D014493:United States Department of Veterans Affairs; D014728:Veterans / Q000706:statistics & numerical data*; D019562:Viral Load