Effects of frailty, geriatric syndromes, and comorbidity on mortality and quality of life in older adults with HIV

BMC Geriatrics

Research

Fátima Brañas¹  Pablo Ryan²  María Luisa Montes³  Alfonso Cabello⁴  Fernando Dronda⁵  Matilde Sánchez-Conde⁵  Isabel Machuca⁶  María Jesús Bustinduy⁷  Antonio Antela⁸  Margarita Ramírez⁹  Miguel Torralba^1,10  Jorge Vergas^1,11  María José Galindo^1,12 

[1] Geriatrics Department, Hospital Universitario Infanta Leonor, Fundación para la Investigación e Innovación Biomédica H.U Infanta Leonor y H.U. Sureste. Universidad Complutense, Madrid, Spain;HIV Clinic. Hospital Universitario Infanta Leonor, Fundación para la Investigación e Innovación Biomédica H.U Infanta Leonor y H.U. Sureste. Universidad Complutense. CIBERINFEC, Madrid, Spain;HIV Unit/Internal Medicine Department, Hospital Universitario La Paz. IdiPAZ, Madrid, Spain;Infectious Diseases Department, Fundación Jiménez Díaz, Madrid, Spain;Infectious Diseases Department, Hospital Universitario Ramón y Cajal. IRYCIS. CIBERINFEC, Madrid, Spain;Infectious Diseases Department, Hospital Universitario Reina Sofía, Córdoba, Spain;Infectious Diseases Department, Hospital de Donostia, San Sebastián, Spain;Infectious Diseases Unit, Hospital Clínico Universitario de Santiago de Compostela, Universidad de Santiago de Compostela, Madrid, Spain;Infectious Diseases Unit, Hospital General Universitario Gregorio Marañón, Madrid, Spain;Internal Medicine Department, Hospital Universitario de Guadalajara. Universidad de Alcalá, Guadalajara, Spain;Internal Medicine/ Infectious Diseases Department, Hospital Universitario Clínico San Carlos, Madrid, Spain;Internal Medicine/ Infectious Diseases Department, Hospital Universitario Clínico de Valencia, Valencia, Spain;

关键词: HIV;    Frailty;    Geriatric syndromes;    Mortality;    Quality of life;   

DOI  :  10.1186/s12877-022-03719-8

 received in 2022-10-09, accepted in 2022-12-27,  发布年份 2022

来源: Springer

【 摘 要 】

BackgroundTo understand the effects of frailty, geriatric syndromes, and comorbidity on quality of life and mortality in older adults with HIV (OAWH).MethodsCross-sectional study of the FUNCFRAIL multicenter cohort. The setting was outpatient HIV-Clinic. OAWH, 50 year or over were included. We recorded sociodemographic data, HIV infection-related data, comorbidity, frailty, geriatric syndromes (depression, cognitive impairment, falls and malnutrition), quality of life (QOL) and the estimated risk of all-cause 5-year mortality by VACS Index. Association of frailty with geriatric syndromes and comorbidity was evaluated using the Cochran-Mantel-Haenszel test.ResultsSeven hundred ninety six patients were included. 24.7% were women, mean age was 58.2 (6.3). 14.7% were 65 or over. 517 (65%) patients had ≥3 comorbidities, ≥ 1 geriatric syndrome and/or frailty. There were significant differences in the estimated risk of mortality [(frailty 10.8%) vs. (≥ 3 comorbidities 8.2%) vs. (≥ 1 geriatric syndrome 8.2%) vs. (nothing 6.2%); p = 0.01] and in the prevalence of fair or poor QOL [(frailty 71.7%) vs. (≥ 3 comorbidities 52%) vs. (≥ 1 geriatric syndrome 58.4%) vs. (nothing 51%); p = 0.01]. Cognitive impairment was significantly associated to mortality (8.7% vs. 6.2%; p = 0.02) and depression to poor QOL [76.5% vs. 50%; p = 0.01].ConclusionsFrailty, geriatric syndromes, and comorbidity had negative effects on mortality and QOL, but frailty had the greatest negative effect out of the three factors. Our results should be a wake-up call to standardize the screening for frailty and geriatric syndromes in OAWH in the clinical practice.Trial registrationNCT03558438.

【 授权许可】

CC BY   
© The Author(s) 2023

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