Functional status of persons with HIV infection in an ambulatory setting

The objective of this project was to study the functional status of HIV-infected persons seen in an ambulatory care setting. We reviewed baseline clinical and demographic data on patients with HIV infection presenting for care between December 1988 and May 1991 at the HIV Clinic of the Johns Hopkins Hospital, an urban, primary care institution. Functional status was assessed at baseline in a comprehensive psychosocial assessment. Patients were asked to report on their ability to perform six activities of daily living (ADL) and nine instrumental activities of daily living (IADL). The main outcome measures were dependency in one or more ADL and death as ascertained by review of clinic death records and Maryland State Death Registries. All 728 patients had assessments of functional status. Of these, 18% reported dependencies in one or more activity, with most of these (14%) reporting dependencies in IADLs only. Dependencies were more common in persons with an AIDS diagnosis (32% vs. 15%, p < 0.001). The majority of the dependencies reported by AIDS patients were also in IADLs. Mean CD4 counts were lower for persons reporting dependencies than for those who reported no dependencies (p = 0.02). No independent associations were found between functional limitation and demographic variables. The risk of death was greater in patients with dependencies than in patients with no dependencies, even when adjusting for CD4 count and AIDS diagnosis (O.R. = 2.32, p = 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)