title: Risk factors for falls in HIV-infected persons.
abstract: BACKGROUND
  The incidence of and risk factors for falls in HIV-1-infected persons are unknown.
  
  
  METHODS
  Fall history during the prior 12 months, medical diagnoses, and functional assessments were collected on HIV-infected persons 45-65 years of age receiving effective antiretroviral therapy. Fall risk was evaluated using univariate and multivariate regression analyses.
  
  
  RESULTS
  Of 359 subjects, 250 persons (70%) reported no falls, 109 (30%) had ≥1 fall; and 66 (18%) were recurrent fallers. Females, whites, and smokers were more likely to be recurrent fallers (P ≤ 0.05). HIV-related characteristics including current and nadir CD4 T-cell count, estimated HIV duration, and Veterans Aging Cohort Study Index scores were not predictors of falls (all P ≥ 0.09); didanosine recipients were more likely to be recurrent fallers (P = 0.04). The odds of falling increased 1.7 for each comorbidity and 1.4 for each medication (P < 0.001) and were higher in persons with cardiovascular disease, hypertension, dementia, neuropathy, arthritis, chronic pain, psychiatric disease, frailty, or disability [all odds ratio (OR) ≥ 1.8; P ≤ 0.05]. Beta-blockers, antidepressants, antipsychotics, sedatives, and opiates were independently associated with falling (all OR ≥ 2.7; P ≤ 0.01). Female gender, diabetes, antidepressants, sedatives, opiates, didanosine, exhaustion, weight loss, and difficulty with balance were the most significant predictors of falls in logistic regression (all OR ≥ 2.5; P ≤ 0.05).
  
  
  CONCLUSIONS
  Middle-aged HIV-infected adults have high fall risk. Multiple comorbidities, medications, and functional impairment were predictive of falls, but surrogate markers of HIV infection or an HIV-specific multimorbidity index were not. Fall risk should be assessed routinely as part of the care of HIV-infected persons.
authors.affiliation: Division of Infectious Diseases, Department of Medicine, University of Colorado Denver, CO 80045, USA. kristine.erlandson@ucdenver.edu
authors.forename: Kristine M
authors.initials: KM
authors.lastname: Erlandson
authors.forename: Amanda A
authors.initials: AA
authors.lastname: Allshouse
authors.forename: Catherine M
authors.initials: CM
authors.lastname: Jankowski
authors.forename: Syki
authors.initials: S
authors.lastname: Duong
authors.forename: Samantha
authors.initials: S
authors.lastname: MaWhinney
authors.forename: Wendy M
authors.initials: WM
authors.lastname: Kohrt
authors.forename: Thomas B
authors.initials: TB
authors.lastname: Campbell
mesh_terms: D000058:Accidental Falls / Q000706:statistics & numerical data*; D000368:Aged; D019380:Anti-HIV Agents / Q000008:administration & dosage; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy / Q000821:virology; D015497:HIV-1 / Q000302:isolation & purification; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D012307:Risk Factors
chemical_list: D019380:Anti-HIV Agents