Frailty as a predictor of falls in HIV-infected and uninfected women

Anjali Sharma, Donald R. Hoover, Qiuhu Shi, Deborah R. Gustafson, Michael W. Plankey, Phyllis C. Tien, Kathleen M. Weber, Michael T. Yin

Research output: Contribution to journalArticle

Abstract

Background: Frailty and falls occur commonly and prematurely in HIV-infected populations. Whether frailty in middle-age predicts future falls among HIV-infected women is unknown. Methods: We evaluated associations of frailty with single and recurrent falls 10 years later among 729 HIV-infected and 326 uninfected women in the Women’s Interagency HIV Study (WIHS) with frailty measured in 2005 and self-reported falls in 2014–2016. Frailty was defined as ≥3 of 5 Fried Frailty Index components: slow gait, reduced grip strength, exhaustion, unintentional weight loss and low physical activity. Stepwise logistic regression models determined odds of single (versus 0) or recurrent falls (≥2 versus 0) during the 2-year period; separate models evaluated frailty components. Results: HIV-infected women were older (median 42 versus 39 years; P<0.0001) and more often frail (14% versus 9%; P=0.04) than uninfected women. Over 2 years, 40% of HIV-infected versus 39% of uninfected women reported a fall (single fall in 15% HIV+ versus 18% HIV-women; recurrent falls in 25% HIV+ versus 20% HIV-women [overall P=0.20]). In multivariate models, frailty independently predicted recurrent falls (adjusted odds ratio [aOR] 1.84, 95% CI: 1.13, 2.97; P=0.01), but not a single fall. Among frailty components, unintentional weight loss independently predicted single fall (aOR 2.31, 95% CI: 1.28, 4.17; P=0.005); unintentional weight loss (aOR 2.26, 95% CI: 1.32, 3.86; P=0.003) and exhaustion (aOR 1.66, 95% CI: 1.10, 2.50; P=0.02) independently predicted recurrent falls. Conclusions: Early frailty measurement among middle-aged women with or at-risk for HIV may be a useful tool to assess future fall risk.

Original languageEnglish (US)
Pages (from-to)51-61
Number of pages11
JournalAntiviral Therapy
Volume24
Issue number1
DOIs
StatePublished - Jan 1 2019

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HIV
Odds Ratio
Weight Loss
Logistic Models
Hand Strength
Gait
Exercise
Population

ASJC Scopus subject areas

  • Pharmacology
  • Pharmacology (medical)
  • Infectious Diseases

Cite this

Sharma, A., Hoover, D. R., Shi, Q., Gustafson, D. R., Plankey, M. W., Tien, P. C., ... Yin, M. T. (2019). Frailty as a predictor of falls in HIV-infected and uninfected women. Antiviral Therapy, 24(1), 51-61. https://doi.org/10.3851/IMP3286

Frailty as a predictor of falls in HIV-infected and uninfected women. / Sharma, Anjali; Hoover, Donald R.; Shi, Qiuhu; Gustafson, Deborah R.; Plankey, Michael W.; Tien, Phyllis C.; Weber, Kathleen M.; Yin, Michael T.

In: Antiviral Therapy, Vol. 24, No. 1, 01.01.2019, p. 51-61.

Research output: Contribution to journalArticle

Sharma, A, Hoover, DR, Shi, Q, Gustafson, DR, Plankey, MW, Tien, PC, Weber, KM & Yin, MT 2019, 'Frailty as a predictor of falls in HIV-infected and uninfected women', Antiviral Therapy, vol. 24, no. 1, pp. 51-61. https://doi.org/10.3851/IMP3286
Sharma A, Hoover DR, Shi Q, Gustafson DR, Plankey MW, Tien PC et al. Frailty as a predictor of falls in HIV-infected and uninfected women. Antiviral Therapy. 2019 Jan 1;24(1):51-61. https://doi.org/10.3851/IMP3286
Sharma, Anjali ; Hoover, Donald R. ; Shi, Qiuhu ; Gustafson, Deborah R. ; Plankey, Michael W. ; Tien, Phyllis C. ; Weber, Kathleen M. ; Yin, Michael T. / Frailty as a predictor of falls in HIV-infected and uninfected women. In: Antiviral Therapy. 2019 ; Vol. 24, No. 1. pp. 51-61.
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abstract = "Background: Frailty and falls occur commonly and prematurely in HIV-infected populations. Whether frailty in middle-age predicts future falls among HIV-infected women is unknown. Methods: We evaluated associations of frailty with single and recurrent falls 10 years later among 729 HIV-infected and 326 uninfected women in the Women’s Interagency HIV Study (WIHS) with frailty measured in 2005 and self-reported falls in 2014–2016. Frailty was defined as ≥3 of 5 Fried Frailty Index components: slow gait, reduced grip strength, exhaustion, unintentional weight loss and low physical activity. Stepwise logistic regression models determined odds of single (versus 0) or recurrent falls (≥2 versus 0) during the 2-year period; separate models evaluated frailty components. Results: HIV-infected women were older (median 42 versus 39 years; P<0.0001) and more often frail (14{\%} versus 9{\%}; P=0.04) than uninfected women. Over 2 years, 40{\%} of HIV-infected versus 39{\%} of uninfected women reported a fall (single fall in 15{\%} HIV+ versus 18{\%} HIV-women; recurrent falls in 25{\%} HIV+ versus 20{\%} HIV-women [overall P=0.20]). In multivariate models, frailty independently predicted recurrent falls (adjusted odds ratio [aOR] 1.84, 95{\%} CI: 1.13, 2.97; P=0.01), but not a single fall. Among frailty components, unintentional weight loss independently predicted single fall (aOR 2.31, 95{\%} CI: 1.28, 4.17; P=0.005); unintentional weight loss (aOR 2.26, 95{\%} CI: 1.32, 3.86; P=0.003) and exhaustion (aOR 1.66, 95{\%} CI: 1.10, 2.50; P=0.02) independently predicted recurrent falls. Conclusions: Early frailty measurement among middle-aged women with or at-risk for HIV may be a useful tool to assess future fall risk.",
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AU - Hoover, Donald R.

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AU - Gustafson, Deborah R.

AU - Plankey, Michael W.

AU - Tien, Phyllis C.

AU - Weber, Kathleen M.

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AB - Background: Frailty and falls occur commonly and prematurely in HIV-infected populations. Whether frailty in middle-age predicts future falls among HIV-infected women is unknown. Methods: We evaluated associations of frailty with single and recurrent falls 10 years later among 729 HIV-infected and 326 uninfected women in the Women’s Interagency HIV Study (WIHS) with frailty measured in 2005 and self-reported falls in 2014–2016. Frailty was defined as ≥3 of 5 Fried Frailty Index components: slow gait, reduced grip strength, exhaustion, unintentional weight loss and low physical activity. Stepwise logistic regression models determined odds of single (versus 0) or recurrent falls (≥2 versus 0) during the 2-year period; separate models evaluated frailty components. Results: HIV-infected women were older (median 42 versus 39 years; P<0.0001) and more often frail (14% versus 9%; P=0.04) than uninfected women. Over 2 years, 40% of HIV-infected versus 39% of uninfected women reported a fall (single fall in 15% HIV+ versus 18% HIV-women; recurrent falls in 25% HIV+ versus 20% HIV-women [overall P=0.20]). In multivariate models, frailty independently predicted recurrent falls (adjusted odds ratio [aOR] 1.84, 95% CI: 1.13, 2.97; P=0.01), but not a single fall. Among frailty components, unintentional weight loss independently predicted single fall (aOR 2.31, 95% CI: 1.28, 4.17; P=0.005); unintentional weight loss (aOR 2.26, 95% CI: 1.32, 3.86; P=0.003) and exhaustion (aOR 1.66, 95% CI: 1.10, 2.50; P=0.02) independently predicted recurrent falls. Conclusions: Early frailty measurement among middle-aged women with or at-risk for HIV may be a useful tool to assess future fall risk.

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