Effects of frailty, geriatric syndromes, and comorbidity on mortality and quality of life in older adults with HIV.

Autor: Brañas F; Geriatrics Department, Hospital Universitario Infanta Leonor, Fundación para la Investigación e Innovación Biomédica H.U Infanta Leonor y H.U. Sureste. Universidad Complutense, Madrid, Spain. fbranas@gmail.com., Torralba M; Internal Medicine Department, Hospital Universitario de Guadalajara. Universidad de Alcalá, Guadalajara, Spain., Antela A; Infectious Diseases Unit, Hospital Clínico Universitario de Santiago de Compostela, Universidad de Santiago de Compostela, Madrid, Spain., Vergas J; Internal Medicine/ Infectious Diseases Department, Hospital Universitario Clínico San Carlos, Madrid, Spain., Ramírez M; Infectious Diseases Unit, Hospital General Universitario Gregorio Marañón, Madrid, Spain., Ryan P; HIV Clinic. Hospital Universitario Infanta Leonor, Fundación para la Investigación e Innovación Biomédica H.U Infanta Leonor y H.U. Sureste. Universidad Complutense. CIBERINFEC, Madrid, Spain., Dronda F; Infectious Diseases Department, Hospital Universitario Ramón y Cajal. IRYCIS. CIBERINFEC, Madrid, Spain., Galindo MJ; Internal Medicine/ Infectious Diseases Department, Hospital Universitario Clínico de Valencia, Valencia, Spain., Machuca I; Infectious Diseases Department, Hospital Universitario Reina Sofía, Córdoba, Spain., Bustinduy MJ; Infectious Diseases Department, Hospital de Donostia, San Sebastián, Spain., Cabello A; Infectious Diseases Department, Fundación Jiménez Díaz, Madrid, Spain., Montes ML; HIV Unit/Internal Medicine Department, Hospital Universitario La Paz. IdiPAZ, Madrid, Spain., Sánchez-Conde M; Infectious Diseases Department, Hospital Universitario Ramón y Cajal. IRYCIS. CIBERINFEC, Madrid, Spain.
Jazyk: angličtina
Zdroj: BMC geriatrics [BMC Geriatr] 2023 Jan 03; Vol. 23 (1), pp. 4. Date of Electronic Publication: 2023 Jan 03.
DOI: 10.1186/s12877-022-03719-8
Abstrakt: Background: To understand the effects of frailty, geriatric syndromes, and comorbidity on quality of life and mortality in older adults with HIV (OAWH).
Methods: Cross-sectional study of the FUNCFRAIL multicenter cohort. The setting was outpatient HIV-Clinic. OAWH, 50 year or over were included. We recorded sociodemographic data, HIV infection-related data, comorbidity, frailty, geriatric syndromes (depression, cognitive impairment, falls and malnutrition), quality of life (QOL) and the estimated risk of all-cause 5-year mortality by VACS Index. Association of frailty with geriatric syndromes and comorbidity was evaluated using the Cochran-Mantel-Haenszel test.
Results: Seven hundred ninety six patients were included. 24.7% were women, mean age was 58.2 (6.3). 14.7% were 65 or over. 517 (65%) patients had ≥3 comorbidities, ≥ 1 geriatric syndrome and/or frailty. There were significant differences in the estimated risk of mortality [(frailty 10.8%) vs. (≥ 3 comorbidities 8.2%) vs. (≥ 1 geriatric syndrome 8.2%) vs. (nothing 6.2%); p = 0.01] and in the prevalence of fair or poor QOL [(frailty 71.7%) vs. (≥ 3 comorbidities 52%) vs. (≥ 1 geriatric syndrome 58.4%) vs. (nothing 51%); p = 0.01]. Cognitive impairment was significantly associated to mortality (8.7% vs. 6.2%; p = 0.02) and depression to poor QOL [76.5% vs. 50%; p = 0.01].
Conclusions: Frailty, geriatric syndromes, and comorbidity had negative effects on mortality and QOL, but frailty had the greatest negative effect out of the three factors. Our results should be a wake-up call to standardize the screening for frailty and geriatric syndromes in OAWH in the clinical practice.
Trial Registration: NCT03558438.
(© 2023. The Author(s).)
Databáze: MEDLINE
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