A new frailty syndrome: central obesity and frailty in older adults with the human immunodeficiency virus.
OBJECTIVE
To evaluate the relationships between body composition and physical frailty in community-dwelling older adults with the human immunodeficiency virus (HIV) (HOA).


METHODS
Cross-sectional.


METHODS
Academic hospital-based infectious disease clinic in Rochester, New York.


METHODS
Forty community-dwelling HOA aged 50 and older undergoing antiretroviral therapy who were able to ambulate without assistive devices with a mean age of 58, a mean BMI of 29.0 kg/m(2), mean CD4 count of 569 cells/mL, and a mean duration since HIV diagnosis of 17 years; 28% were female and 57% Caucasian.


METHODS
Subjective and objective measures of functional status were evaluated using the Physical Performance Test (PPT), the graded treadmill test, knee strength, gait speed, balance, and the Functional Status Questionnaire (FSQ). Body composition was evaluated using dual-energy X-ray absorptiometry (DXA) and magnetic resonance imaging (MRI).


RESULTS
Sixty percent (25/40) of the participants met standard criteria for physical frailty. Frail (FR) and nonfrail (NF) participants were comparable in age, sex, CD4 count, and viral load. FR HOA had greater impairments in PPT, peak oxygen uptake, FSQ, walking speed, balance, and muscle quality than NF HOA. FR HOA had a greater body mass index (BMI), fat mass, and truncal fat with lipodystrophy. Moreover, PPT score was inversely related to trunk fat (correlation coefficient (r) = -0.34; P = .04) and ratio of intermuscular fat to total fat (r = -0.60; P = .02) after adjusting for covariates.


CONCLUSIONS
HOA represent an emerging cohort of older adults who frequently experience frailty at a much younger age than the general older population. Central obesity and fat redistribution are important predictors of frailty in community-dwelling HOA. These findings suggest that physical frailty in HOA may be amenable to lifestyle interventions, especially exercise and diet therapy.
Division of Geriatrics and Aging, Highland Hospital, School of Medicine and Dentistry, University of Rochester, Rochester, New York 14692, USA. krupa_shah@urmc.rochester.edu
Krupa
K
Shah
Tiffany N
TN
Hilton
Lauren
L
Myers
Jonathan F
JF
Pinto
Amneris E
AE
Luque
William J
WJ
Hall
D015502:Absorptiometry, Photon; D000368:Aged; D001823:Body Composition; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D005260:Female; D016330:Frail Elderly; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009518:New York / Q000453:epidemiology; D056128:Obesity, Abdominal / Q000150:complications*; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires