Prognostic Factors of Physical Function Decline Among Middle-Aged Adults With HIV

Area of Science:

• Gerontology and HIV Medicine
• Clinical Research and Epidemiology

Background:

• The PREPARE study observed minor overall physical function decline in people with HIV (PWH).
• Significant individual variability in physical function changes was noted among PWH.
• Exploratory analysis aimed to identify PWH most susceptible to physical function decline.

Purpose of the Study:

• To identify demographic and clinical factors associated with physical function decline in people with HIV (PWH).
• To pinpoint individuals within the PWH population at greatest risk for functional impairment.

Main Methods:

• Annualized rates of change were calculated for chair rise, gait speed, and grip strength using linear mixed-effect models.
• Physical function decline was defined as performance below the 20th percentile in at least one measure.
• Log-binomial regression models assessed associations between baseline characteristics and physical function decline.

Main Results:

• 52% of 569 participants experienced physical function decline.
• Higher risk of decline was observed in females (RR 1.32) and non-Whites (RR 1.23).
• Increased risk was linked to depression treatment history, higher BMI, frailty, and elevated inflammatory markers (hs-CRP, IL-6).

Conclusions:

• PWH with depression history, high BMI, inflammation, or early functional impairment are at elevated risk.
• Targeted early interventions are recommended to preserve physical function in at-risk PWH.
• Proactive strategies can mitigate age-related functional decline in people living with HIV.