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Measuring Frailty in HIV-infected Individuals. Identification of Frail Patients is the First Step to Amelioration and Reversal of Frailty
Published on: July 24, 2013
Neurocognitive functioning predicts frailty index in HIV.
Hannah Oppenheim1, Emily W Paolillo1, Raeanne C Moore1
1From the University of California, San Diego, School of Medicine (H.O.); San Diego State University/University of California, San Diego Joint Doctoral Program in Clinical Psychology (E.W.P.); Departments of Psychiatry (R.C.M., D.V.J., I.G., D.J.M.), Neurosciences (R.J.E.), and Medicine (S.L.L.), University of California, San Diego; VA San Diego Healthcare System (R.C.M.), CA; and Sam and Rose Stein Institute for Research on Aging (D.V.J.), University of California, San Diego.
A higher frailty index in people with HIV/AIDS is linked to poorer neurocognitive function. This finding helps identify individuals at risk for cognitive impairment.
Area of Science:
- Gerontology and Geriatric Medicine
- Infectious Diseases and Virology
- Neuroscience and Neuroimaging
Background:
- Aging populations living with HIV/AIDS (PLWHA) face complex health challenges.
- Neurocognitive impairment is a significant concern for PLWHA, impacting quality of life.
- Frailty, a measure of accumulated health deficits, is increasingly recognized in aging populations.
Purpose of the Study:
- To investigate the association between a frailty index and neurocognitive functioning in PLWHA.
- To determine if a standardized frailty measure can identify PLWHA at risk for cognitive decline.
Main Methods:
- Cross-sectional analysis of 811 PLWHA (aged 18-79) from the HIV Neurobehavioral Research Program (2002-2016).
- A frailty index comprising 26 health deficits (general and HIV-specific) was calculated.
- Multiple linear regression examined the relationship between frailty index scores and comprehensive neurocognitive assessments.
Main Results:
- Higher frailty index scores were significantly associated with worse global neurocognitive functioning (p < 0.001).
- Specific cognitive domains, including verbal fluency, executive functioning, processing speed, and motor skills, were negatively impacted by higher frailty.
- Adjustments for covariates like age and employment did not alter the observed association.
Conclusions:
- The frailty index is a valuable tool for quantifying health deficits in PLWHA.
- Clinicians can utilize a standardized frailty index to identify PLWHA at elevated risk of neurocognitive impairment.
- Early identification through frailty assessment may facilitate timely interventions for cognitive health in PLWHA.
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