title: Correlates of Prevalent Disability Among HIV-Infected Elderly Patients.
abstract: The growing elderly population of HIV-infected patients is leading to a significant epidemiological transition and HIV infection has been proposed as a premature and accelerated aging model rending the individual more susceptible to premature disability. However, the determinants of disability among this emergent population are still lacking. Therefore, the aim of this study is to determine the correlates of prevalent disability in adults ≥50 years with HIV infection. A cross-sectional study of 184 HIV-infected adults receiving ambulatory care in an HIV clinic of a tertiary care, university-affiliated hospital in Mexico City was conducted. Disability for instrumental (IADL) and basic activities of daily living (ADL) was established. Sociodemographic factors, clinical variables, current CD4(+) cell count, and HIV viral load (VL) were tested as potential determinants of disability. Multivariate logistic regression analyses were used to identify the correlates of both types of disability. The mean age was 59.3 years. All participants were receiving highly active antiretroviral therapy. Of participants 17.9% had disability for IADL and 26.1% for ADL. Multivariate logistic regression analyses indicated that being older; having a lower CD4(+) cell count, and having a detectable HIV VL were independently associated with both types of disability. In addition, educational level was also independently associated with ADL disability. Age, educational level, low CD4(+) cell count, and detectable HIV VL were independently associated with disability. Whether effective and timely antiretroviral therapy will reduce the risk of disability in HIV-infected elderly patients needs to be evaluated.
authors.affiliation: 1 Departmento of Geriatría, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán , Mexico City, Mexico .|2 Centre de Recherche Inserm, U897, Bordeaux, France and University Victor Segalen Bordeaux 2 , Bordeaux, France .
authors.forename: José Alberto
authors.initials: JA
authors.lastname: Ávila-Funes
authors.affiliation: 3 Departmento de Infectología, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán , Mexico City, Mexico .|4 División de Investigación de la Facultad de Medicina, Universidad Nacional Autónoma de México , Mexico City, Mexico .
authors.forename: Pablo Francisco
authors.initials: PF
authors.lastname: Belaunzarán-Zamudio
authors.affiliation: 1 Departmento of Geriatría, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán , Mexico City, Mexico .
authors.forename: Oscar
authors.initials: O
authors.lastname: Tamez-Rivera
authors.affiliation: 3 Departmento de Infectología, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán , Mexico City, Mexico .
authors.forename: Brenda
authors.initials: B
authors.lastname: Crabtree-Ramírez
authors.affiliation: 1 Departmento of Geriatría, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán , Mexico City, Mexico .
authors.forename: Ana Patricia
authors.initials: AP
authors.lastname: Navarrete-Reyes
authors.affiliation: 3 Departmento de Infectología, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán , Mexico City, Mexico .
authors.forename: Jennifer
authors.initials: J
authors.lastname: Cuellar-Rodríguez
authors.affiliation: 3 Departmento de Infectología, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán , Mexico City, Mexico .
authors.forename: Juan
authors.initials: J
authors.lastname: Sierra-Madero
authors.affiliation: 2 Centre de Recherche Inserm, U897, Bordeaux, France and University Victor Segalen Bordeaux 2 , Bordeaux, France .
authors.forename: Hélène
authors.initials: H
authors.lastname: Amieva
mesh_terms: D000203:Activities of Daily Living; D000375:Aging; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D023241:Antiretroviral Therapy, Highly Active; D018791:CD4 Lymphocyte Count; D003430:Cross-Sectional Studies; D006233:Persons with Disabilities; D004522:Educational Status; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000453:epidemiology / Q000276:immunology*; D006801:Humans; D008297:Male; D008800:Mexico / Q000453:epidemiology; D008875:Middle Aged; D062606:Tertiary Care Centers; D019562:Viral Load
chemical_list: D019380:Anti-HIV Agents