title: Geriatric Syndromes in Older HIV-Infected Adults.
abstract: BACKGROUND
  Geriatric syndromes such as falls, frailty, and functional impairment are multifactorial conditions used to identify vulnerable older adults. Limited data exist on these conditions in older HIV-infected adults, and no studies have comprehensively examined these conditions.
  
  
  METHODS
  Geriatric syndromes including falls, urinary incontinence, functional impairment, frailty, sensory impairment, depression, and cognitive impairment were measured in a cross-sectional study of HIV-infected adults aged 50 years and older who had an undetectable viral load on antiretroviral therapy. We examined both HIV and non-HIV-related predictors of geriatric syndromes including sociodemographics, number of comorbidities and nonantiretroviral medications, and HIV-specific variables in multivariate analyses.
  
  
  RESULTS
  We studied 155 participants with a median age of 57 (interquartile range: 54-62) and 94% were men. Prefrailty (56%), difficulty with instrumental activities of daily living (46%), and cognitive impairment (47%) were the most frequent geriatric syndromes. Lower CD4 nadir incidence rate ratio [IRR: 1.16, 95% (confidence interval) CI: 1.06 to 1.26], non-white race (IRR: 1.38, 95% CI: 1.10 to 1.74), and increasing number of comorbidities (IRR: 1.09, 95% CI: 1.03 to 1.15) were associated with increased risk of having more geriatric syndromes.
  
  
  CONCLUSIONS
  Geriatric syndromes are common in older HIV-infected adults. Treatment of comorbidities and early initiation of antiretroviral therapy may help to prevent development of these age-related complications. Clinical care of older HIV-infected adults should consider incorporation of geriatric principles.
authors.affiliation: *Division of Geriatrics, Department of Medicine, University of California San Francisco, San Francisco, CA; †Section of Geriatrics and Palliative Medicine, San Francisco Veterans Affairs Medical Center, San Francisco, CA; ‡Department of Neurology, University of California San Francisco, Memory and Aging Center, San Francisco, CA; §Division of HIV/AIDS, Department of Medicine, University of California San Francisco, San Francisco, CA; ‖Division of Infectious Diseases, Department of Medicine, University of California San Francisco, San Francisco, CA; ¶Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA; and #Section of Infectious Diseases, San Francisco Veterans Affairs Medical Center, San Francisco, CA.
authors.forename: Meredith
authors.initials: M
authors.lastname: Greene
authors.forename: Kenneth E
authors.initials: KE
authors.lastname: Covinsky
authors.forename: Victor
authors.initials: V
authors.lastname: Valcour
authors.forename: Yinghui
authors.initials: Y
authors.lastname: Miao
authors.forename: Joy
authors.initials: J
authors.lastname: Madamba
authors.forename: Harry
authors.initials: H
authors.lastname: Lampiris
authors.forename: Irena Stijacic
authors.initials: IS
authors.lastname: Cenzer
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Martin
authors.forename: Steven G
authors.initials: SG
authors.lastname: Deeks
mesh_terms: D000058:Accidental Falls; D000375:Aging; D003072:Cognition Disorders / Q000453:epidemiology; D015331:Cohort Studies; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000473:pathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D014549:Urinary Incontinence / Q000453:epidemiology