Related Experiment Video
Updated: May 23, 2025
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
Cardiometabolic disease among frailty phenotype clusters in adults aging with HIV
Raymond Jones1, Ene M Enogela1, Stephanie A Ruderman2
1University of Alabama at Birmingham, Birmingham, AL, USA.
Insights
Frailty characteristics, independently and together, increase cardiometabolic disease risk in people with HIV (PWH). Distinct frailty clusters are linked to higher rates of conditions like diabetes and hypertension in PWH.
Area of Science:
- Gerontology
- Infectious Diseases
- Cardiology
Background:
- Age-related morbidity, including frailty and cardiometabolic disease, is rising among people living with HIV (PWH).
- Frailty characteristics can independently and synergistically contribute to cardiometabolic disease development in PWH.
Purpose of the Study:
- To determine the prevalence of unique frailty clusters in a large, diverse cohort of PWH.
- To assess the prevalence ratios of cardiometabolic diseases within identified frailty clusters among PWH in clinical care.
Main Methods:
- Cross-sectional analysis of a longitudinal clinical cohort.
- Utilized the validated, modified Fried Phenotype from patient-reported outcomes.
- Clustered frailty characteristics and cardiometabolic diseases (including multimorbidity) in 4,856 PWH from the CNICS network.
Main Results:
- 16% of PWH were frail, 45% pre-frail, and 40% robust (mean age 61).
- Hypertension, dyslipidemia, and diabetes were most common in frail PWH.
- Specific clusters like 'fatigue + poor mobility' showed significantly higher risks for cerebrovascular disease, diabetes, and obesity compared to robust PWH.
Conclusions:
- Frailty components are associated with increased cardiometabolic disease prevalence in PWH.
- Identified distinct frailty clusters associated with elevated cardiometabolic disease risk.
- Findings highlight the complex interplay between frailty and cardiometabolic health in the aging HIV population.
Background:
Age-related morbidity, including frailty and cardiometabolic disease has become increasingly prevalent among people living with HIV (PWH), and each frailty characteristic may, independently and synergistically, play a role in cardiometabolic disease.
Objective:
To evaluate the prevalence of unique frailty clusters and the prevalence ratios of cardiometabolic diseases within frailty clusters among a large diverse cohort of PWH in clinical care.
Design:
Cross-sectional analyses within longitudinal clinical cohort.
Setting:
The Center for AIDS Research Network of Integrated Clinical Systems (CNICS) from 8 Clinics PARTICIPANTS: 4,856 PWH, mean age 61 years. 16 % frail, 45 % pre-frail, 40 % robust.
Measurements:
The validated, modified Fried Phenotype from patient-reported outcomes and clustering (15 clusters) of the frailty characteristics and cardiometabolic diseases (7 diseases and multimorbidity) within each cluster.
Results:
Among 4856 PWH (age: 61 ± 6 years), the prevalence of frail, pre-frail, and robust was 16 %, 45 %, and 40 %, respectively. The most prevalent cardiometabolic disease among frail PWH was hypertension (62.6 %), followed by dyslipidemia (58.8 %) and diabetes (31.4 %). Among pre-frail PWH, the most prevalent cardiometabolic diseases were dyslipidemia (65.8 %), hypertension (61.8 %), and obesity (30.5 %). The prevalence of cardiometabolic disease among frailty clusters varied. For example, PWH in the "fatigue + poor mobility" cluster had a greater prevalence of cerebrovascular disease (PR: 2.23; 95 % CI: 1.01-4.91), diabetes (1.76; 95 % CI: 1.41-2.21), and obesity (1.66; 95 % CI: 1.35-2.05) when compared with robust PWH. Individuals in the "poor mobility" cluster had a higher prevalence of diabetes (1.37; 95 % CI: 1.15-1.64), hypertension (1.12; 95 % CI: 1.04 - 1.22), and obesity (1.38; 95 % CI: 1.17-1.61) compared with robust PWH.
Conclusions:
The frailty components, independently and synergistically, were associated with an increased prevalence of cardiometabolic disease. This study identified distinct frailty clusters that may be associated with increased prevalence of cardiometabolic disease among PWH.
Related Concept Videos
01:17Pathophysiology of Heart Failure
01:26Aging
Cellular Clock Theory
The cellular clock theory posits that the human lifespan is closely tied to the finite capacity of cells to divide, a phenomenon governed by telomeres, which are protective caps at the ends of...
01:27Psychoneuroimmunology: Cardiovascular Disease
A key area of focus in PNI is the relationship between stress and coronary...
01:29Pulmonary Tuberculosis I
Causative Organism
The primary infectious agent causing tuberculosis is Mycobacterium tuberculosis, a slow-growing, acid-fast, aerobic rod that exhibits sensitivity to heat and ultraviolet light. Instances of Mycobacterium bovis and Mycobacterium avium contributing to the development of TB infection are rare.
Mode of...
01:19The Effect of Aging on Tissues
01:29Bone Disorders
Bone deposition is also affected by the levels of sex hormones like estrogen and testosterone that promote osteoblast activity and bone matrix synthesis. When the level of these hormones decreases due to aging, it causes a reduction in bone deposition. As a result, bone resorption by osteoclasts...