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Assessment, prevalence, and correlates of frailty among middle-aged adults with HIV in rural Uganda

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Abstract

We investigated the prevalence and risk factors for frailty among people with HIV (PWH) in rural Uganda (n = 55, 47% male, mean age 44 years). Frailty was defined according to the Fried criteria with self-reported physical activity level replacing the Minnesota Leisure Time Activity Questionnaire. Alternate classifications for physical activity utilized were the sub-Saharan Africa Activity Questionnaire and the International Physical Activity Questionnaire. Eleven participants (19%) were frail. Frail participants were older (p < 0.001), less likely to be on antiretroviral therapy (p = 0.03), and had higher rates of depression (p < .001) and HIV-associated neurocognitive disorder (p = 0.003). Agreement between physical activity measures was sub-optimal. Prevalence of frailty was high among PWH in rural Uganda, but larger sample sizes and local normative data are needed.

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References

  • Kooij KW, Wit FW, Schouten J et al (2016) HIV infection is independently associated with frailty in middle-aged HIV type 1-infected individuals compared with similar but uninfected controls. AIDS 30:241–250

    Article  CAS  PubMed  Google Scholar 

  • Desquilbet L, Jacobson LP, Fried LP et al (2007) HIV-1 infection is associated with an earlier occurrence of a phenotype related to frailty. J Gerontol A Biol Sci Med Sci 62:1279–1286

    Article  PubMed  Google Scholar 

  • Wada NI, Jacobson LP, Margolick JB et al (2015) The effect of HAART-induced HIV suppression on circulating markers of inflammation and immune activation. AIDS 29:463–471

    Article  CAS  PubMed  Google Scholar 

  • Fried LP, Tangen CM, Walston, J (2001) Frailty in older adults: evidence for a phenotype. J. Gerontol A Biol Sci Med Sci 56 (3) M146–56.

  • Althoff KN, Jacobson LP, Cranston RD et al (2014) Age, comorbidities, and AIDS predict a frailty phenotype in men who have sex with men. J Gerontol A Biol Sci Med Sci 69:189–198

    Article  PubMed  Google Scholar 

  • Leng SX, Margolick JB (2015) Understanding frailty, ageing, and inflammation in HIV infection. Curr HIV/AIDS Rep 12:25–32

    Article  PubMed  PubMed Central  Google Scholar 

  • Wulunggono W, Yunihastuti E, Shatri H, Wahyudi ER, Ophinni Y (2019) Frailty among HIV-1 infected adults under antiretroviral therapy in Indonesia. Curr HIV Res. [Epub ahead of print]

  • Smith B, Skolasky R, Selnes O (2012) Association of HIV-associated neurocognitive disorder with frailty in HIV-1-seropositive men, 3rd International workshop on HIV and Aging.

  • Wallace LM, Ferrara M, Brothers TD et al (2017) Lower frailty is associated with successful cognitive aging among older adults with HIV. AIDS Res Hum Retroviruses 33(2):157–163

    Article  PubMed  PubMed Central  Google Scholar 

  • Womack JA, Goulet JL, Gibert C et al (2013) Physiologic frailty and fragility fracture in HIV-infected male veterans. Clin Infect Dis 56:1498–1504

    Article  PubMed  PubMed Central  Google Scholar 

  • Saylor D, Dickens AM, Sacktor N, Haughey N, Slusher B, Pletnikov M et al (2016) HIV-associated neurocognitive disorder–pathogenesis and prospects for treatment. Nat Rev Neurol 12(4):234–248

    Article  PubMed  PubMed Central  Google Scholar 

  • Pelloquin Regan, Abdo M, MaWhinney S, Jankowski (2020) Physical function and frailty tools in mortality prediction of middle-aged adults with HIV, JAIDS - Volume Publish Ahead of Print

  • Vance DE, Wadley VG, Crowe MG, Raper JL, Ball KK (2011) Cognitive and everyday functioning in older and younger adults with and without HIV. Clin Gerontol 34(5):413–426

    Article  PubMed  PubMed Central  Google Scholar 

  • Valcour V, Shikuma C, Shiramizu B et al (2004) Higher frequency of dementia in older HIV-1 individuals: the Hawaii Aging with HIV-1 Cohort. Neurology 63:822–827

    Article  CAS  PubMed  Google Scholar 

  • Goodkin K, Miller EN, Cox C et al (2017) Effect of ageing on neurocognitive function by stage of HIV infection: evidence from the Multicenter AIDS Cohort Study. Lancet HIV 4:e411–e422

    Article  PubMed  PubMed Central  Google Scholar 

  • Sun-Suslow N, Paolillo EW, Morgan EE (2020) Frailty and HIV disease severity synergistically increase risk of HIV-associated neurocognitive disorders, JAIDS. Volume Publish Ahead of Print.

  • Seider TR, Luo X, Gongvatana A et al (2014) Verbal memory declines more rapidly with age in HIV infected versus uninfected adults. J Clin Exp Neuropsychol 36:356–367

    Article  PubMed  PubMed Central  Google Scholar 

  • Cohen RA, Seider TR, Navia B (2015) HIV effects on age‐associated neurocognitive dysfunction: premature cognitive ageing or neurodegenerative disease? Alzheimers Res Ther, 7:37.Review

  • Tedaldi EM, Minniti NL, Fischer T (2015) HIV-associated neurocognitive disorders: the relationship of HIV infection with physical and social comorbidities. Biomed Res Int 2015:13

    Article  Google Scholar 

  • Nasi M, De Biasi S, Gibellini L et al (2017) Ageing and inflammation in patients with HIV infection. Clin Exp Immunol 187:44–52

    Article  CAS  PubMed  Google Scholar 

  • Morgello S, Gensler G, Sherman S et al (2019) Frailty in medically complex individuals with chronic HIV. AIDS 33(10):1603–1611

    Article  CAS  PubMed  Google Scholar 

  • Saylor D, Kumar A, Nakigozi G et al (2019) Interleukin-6 is associated with mortality and neuropsychiatric outcomes in antiretroviral-naive adults in Rakai, Uganda. J Neuroviro, l 25:735–740

    Article  CAS  Google Scholar 

  • Rubin LH, Saylor D, Nakigozi G (2019) Heterogeneity in neurocognitive change trajectories among people with HIV starting antiretroviral therapy in Rakai, Uganda. J Neurovirol.

  • Weissman MM, Sholomskas D, Pottenger M, Prusoff BA, Locke BZ (1977) Assessing depressive symptoms in five psychiatric populations: a validation study. Am J Epidemiol 106(3):203–214

    Article  CAS  PubMed  Google Scholar 

  • Chelune G, Lehman R (1986) Neuropsychology and personality correlates of patients’ complaints of disability. In: Goldstein G, Tarter R, editors. New York: Plenum Press. p. 95–118.

  • The clinical evaluation of chemotherapeutic agents in cancer (1949) press release. Columbia University Pres, New York

    Google Scholar 

  • Price RW, Sidtis J (1993) Evaluation of the AIDS dementia complex in clinical trials. J Acquir Immune Defic Syndr 3:551–560

    Google Scholar 

  • Saylor DN, Nakigosi G, Nakasujja N, Robertson K, Gray R, Wawer M, Sacktor N (2017) Peripheral neuropathy in HIV-infected and uninfected patients in Rakai, Uganda. Neurology. 89(5):485–96.

  • Taylor HL, Jacobs DR Jr, Schucker B et al (1978) A questionnaire for the assessment of leisure time physical activities. J Chronic Dis 31:741–755

    Article  CAS  PubMed  Google Scholar 

  • Pathai S et al (2013) Frailty in HIV-infected adults in South Africa. J Acquir Immune Defic Syndr 62:43–51

    Article  PubMed  PubMed Central  Google Scholar 

  • Craig CL, Marshall AL, Sjostrom M, Bauman AE, Booth ML, Ainsworth BE et al (2003) International physical activity questionnaire: 12-country reliability and validity. Med Sci Sports Exerc 35:1381–1395

    Article  PubMed  Google Scholar 

  • Wolin KY, Heil DP, Askew S, Matthews CE, Bennett GG (2008) Validation of the International Physical Activity Questionnaire-Short among Blacks. J Phys Act Health 5(5):746–760

    Article  PubMed  PubMed Central  Google Scholar 

  • Sobngwi E, Mbanya JCN, Unwin NC, Aspray TJ, Alberti KGMM (2001) Development and validation of a questionnaire for the assessment of physical activity in epidemiological studies in sub-Saharan Africa. Int J Epidemiol 30(6):1361–1368

    Article  CAS  PubMed  Google Scholar 

  • Sacktor N, Saylor D, Nakigozi G (2019) Effect of HIV subtype and antiretroviral therapy on HIV-associated neurocognitive disorder stage in Rakai, Uganda. J Acquir Immune Defic Syndr 81(2):216–223

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Biritwum RB, Minicuci N, Yawson AE (2016) WHO SAGE Collaboration. Prevalence of and factors associated with frailty and disability in older adults from China, Ghana, India, Mexico, Russia and South Africa. Maturitas. 91:8–18

  • Pengpid S, Peltzer K (2019) Prevalence and associated factors of frailty in community-dwelling older adults in Indonesia, 2014–2015. Int J Environ Res Public Health 17(1):10

    Article  PubMed Central  Google Scholar 

  • Bandeen-Roche K, Xue QL, Ferrucci L et al (2006) Phenotype of frailty: characterization in the women’s health and aging studies. J Gerontol A Biol Sci Med Sci 61:262–266

    Article  PubMed  Google Scholar 

  • Lewis EG, Coles S, Howorth K (2018) The prevalence and characteristics of frailty by frailty phenotype in rural Tanzania. BMC Geriatrics, 10.1186

  • Gustafson DR, Shi Q, Thurn M et al (2016) Frailty and constellations of factors in aging HIV-infected and uninfected women-the Women’s Interagency HIV Study. J Frailty Aging 5(1):43–48

    CAS  PubMed  PubMed Central  Google Scholar 

  • Pathai S, Gilbert C, Weiss HA et al (1999) Frailty in HIV-infected adults in South Africa. J Acquir Immune Defic Syndr 2013(62):43–51

    Google Scholar 

  • Erlandson KM, Allshouse AA, Jankowski CM et al (2013) Association of functional impairment with inflammation and immune activation in HIV type 1-infected adults receiving effective antiretroviral therapy. J Infect Dis 208:249–259

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Zhang W, Nilles TL, Johnson JR, Margolick JB (2015) Regulatory T cells, frailty, and immune activation in men who have sex with men in the Multicenter AIDS Cohort Study. J Gerontol A Biol Sci Med Sci 70:1533–1541

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Ianas V, Berg E, Mohler MJ, Wendel C, Klotz SA (2013) Antiretroviral therapy protects against frailty in HIV-1 infection. J Int Assoc Provid AIDS Care 12:62–66

    Article  PubMed  Google Scholar 

  • Birbeck GL, Kvalsund MP, Byers PA et al (2011) Neuropsychiatric and socioeconomic status impact antiretroviral adherence and mortality in rural Zambia. Am J Trop Med Hyg 85(4):782–789

    Article  PubMed  PubMed Central  Google Scholar 

  • Kvalsund M Chidumayo J,  Hamel T (2018) Factors associated with distal symmetric polyneuropathies in adult Zambians: a cross-sectional, observational study of the role of HIV, non-antiretroviral medication exposures, and nutrition J Neurol Sci. 15(388):61-69

  • Oppenheim H, Paolillo EW, Moore RC et al (2018) Neurocognitive functioning predicts frailty index in HIV. Neurology 91(2):e162–e170

    Article  PubMed  PubMed Central  Google Scholar 

  • Paul RH, Cooley SA, Garcia-Egan PM et al (2018) Cognitive performance and frailty in older HIV-positive adults. J Acquir Immune Defic Syndr 79:375–380

    Article  PubMed  Google Scholar 

  • Adebusoye LA, Cadmus EO, Owolabi MO, Ogunniyi A (2019) Frailty and mortality among older patients in a tertiary hospital in Nigeria. Ghana Med J 53(3):210–216

    Article  PubMed  PubMed Central  Google Scholar 

  • Vaughan L, Corbin AL, Goveas JS (2015) Depression and frailty in later life: a systematic review. Clin Interv Aging 10:1947–1958

    Article  PubMed  PubMed Central  Google Scholar 

  • Kirkness C, Ren J (2015) Race differences: Use of walking speed to identify community-dwelling women at risk for poor health outcomes – Osteoarthritis Initiative Study. Phys Ther 95:955–965

    Article  PubMed  PubMed Central  Google Scholar 

  • Capistrant BD, Glymour MM, Berkman LF (2014) Assessing mobility differences for cross-national comparisons: results from the WHO Study on AGEing and Adult Health. J Am Geriatr Soc 62:329–335

    Article  PubMed  PubMed Central  Google Scholar 

  • Dodds RM, Syddall HE, Cooper R et al (2016) Global variation in grip strength: a systematic review and meta-analysis of normative data. Age Ageing 45:209–216

    Article  PubMed  PubMed Central  Google Scholar 

  • Leong DP, Teo KK, Rangarajan S et al (2016) References ranges of handgrip strength from 125,462 healthy adults in 21 countries: a prospective urban rural epidemiologic (PURE) study. J Cachexia Sarcopenia Muscle 7:536–546

    Article  Google Scholar 

  • Espinoza SE, Hazuda HP (2008) Frailty in older Mexican-American and European American adults: is there an ethnic disparity? J Am Geriatr Soc 56:1744–1749

    Article  PubMed  Google Scholar 

  • Gureje O, Oladeji BD, Abiona T, Chatterji S (2014) Profile and determinants of successful aging in the Ibadan study of ageing. J Am Geriatr Soc 62(5):836–842

    Article  PubMed  PubMed Central  Google Scholar 

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Funding

This study was sponsored by the NIH (MH099733, MH075673, MH080661-08, L30NS088658, NS065729-05S2, P30MH075773, P30AI094189-01A1) with additional funding from the Johns Hopkins Center for Global Health and a World Federation of Neurology Grantsin-Aid.

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Authors and Affiliations

  1. University of North Carolina-Chapel Hill, Chapel Hill, NC, USA

    Alyssa Vecchio & Kevin Robertson

  2. Makerere University, Kampala, Uganda

    Gertrude Nakigozi

  3. Rakai Health Sciences Program, Kalisizo, Uganda

    Noeline Nakasujja, Alice Kisakye, James Batte, Richard Mayanja & Aggrey Anok

  4. Johns Hopkins Bloomberg School of Public Health, Baltimore, USA

    Maria J. Wawer & Leah H. Rubin

  5. Johns Hopkins University School of Medicine, Baltimore, USA

    Ned Sacktor, Leah H. Rubin & Deanna Saylor

Authors
  1. Alyssa Vecchio
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  2. Gertrude Nakigozi
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  3. Noeline Nakasujja
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  4. Alice Kisakye
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  5. James Batte
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  6. Richard Mayanja
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  7. Aggrey Anok
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  8. Kevin Robertson
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  9. Maria J. Wawer
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  10. Ned Sacktor
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  11. Leah H. Rubin
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  12. Deanna Saylor
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Corresponding author

Correspondence to Alyssa Vecchio.

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Vecchio, A., Nakigozi, G., Nakasujja, N. et al. Assessment, prevalence, and correlates of frailty among middle-aged adults with HIV in rural Uganda. J. Neurovirol. 27, 487–492 (2021). https://doi.org/10.1007/s13365-021-00969-x

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  • DOI: https://doi.org/10.1007/s13365-021-00969-x

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