Frailty in people with HIV: a geriatric syndrome approach to aging with HIV

Older persons with HIV (OPWH) are at risk of earlier onset of age-related comorbidities and common geriatric syndromes, notably frailty. The purpose of this review is to provide an update on recent developments related to frailty in OPWH, particularly as they relate to common co-occurrence of frailty with other geriatric syndromes which have an adverse impact on health outcomes.

Recent studies reliably demonstrate that frailty co-occurs with other geriatric syndromes due to common biologic risk factors. They often have an equal or greater impact on mortality and quality of life (QoL) compared to age-related comorbidities. Frailty is potentially reversible and risk factors for progression to or regression from a state of frailty have been identified. Importantly, HIV and Aging care centers have been initiated based on proven geriatric-based principles and frail OPWH should be referred. The role of agism and stigmatization are identified as contributors to states of frailty.

Recent findings focus on the important role geriatric syndromes especially frailty play in determining QoL in OPWH and this has led to efforts to operationalize frailty screening methods and to develop appropriate management protocols to limit or delay the impact of frailty on health.