Frailty as a Predictor of Falls in HIV-Infected and Uninfected Women. Issue 1 (January 2019)

• Record Type: Journal Article
• Authors: Sharma, Anjali; Hoover, Donald R; Shi, Qiuhu; Gustafson, Deborah R; Plankey, Michael W; Tien, Phyllis C; Weber, Kathleen M; Yin, Michael T
• Is Part Of: Antiviral therapy. Volume 24:Issue 1(2019)
• Page Start: 51
• Page End: 61
• Publication Date: 2019-01
• Subjects: Antiviral agents -- Periodicals; Antiviral Agents -- therapeutic use; Virus Diseases -- therapy; Viruses -- drug effects; Antiviral agents; Periodical; Electronic journals; Periodicals; 616.9106
• DOI: 10.3851/IMP3286
• Languages: English
• ISSNs: 1359-6535

Abstract

Background: Frailty and falls occur commonly and prematurely in HIV-infected populations. Whether frailty in middle-age predicts future falls among HIV-infected women is unknown. Methods: We evaluated associations of frailty with single and recurrent falls 10 years later among 729 HIV-infected and 326 uninfected women in the Women's Interagency HIV Study (WIHS) with frailty measured in 2005 and self-reported falls in 2014–2016. Frailty was defined as ≥3 of 5 Fried Frailty Index components: slow gait, reduced grip strength, exhaustion, unintentional weight loss and low physical activity. Stepwise logistic regression models determined odds of single (versus 0) or recurrent falls (≥2 versus 0) during the 2-year period; separate models evaluated frailty components. Results: HIV-infected women were older (median 42 versus 39 years; P <0.0001) and more often frail (14% versus 9%; P =0.04) than uninfected women. Over 2 years, 40% of HIV-infected versus 39% of uninfected women reported a fall (single fall in 15% HIV+ versus 18% HIV-women; recurrent falls in 25% HIV+ versus 20% HIV-women [overall P =0.20]). In multivariate models, frailty independently predicted recurrent falls (adjusted odds ratio [aOR] 1.84, 95% CI: 1.13, 2.97; P =0.01), but not a single fall. Among frailty components, unintentional weight loss independently predicted single fall (aOR 2.31, 95% CI: 1.28, 4.17; P =0.005); unintentional weight loss (aOR 2.26, 95% CI: 1.32, 3.86; P =0.003) and exhaustion (aOR 1.66, 95% CI: 1.10, 2.50; P =0.02) independently predicted recurrent falls. Conclusions: Early frailty measurement among middle-aged women with or at-risk for HIV may be a useful tool to assess future fall risk.