Journal ArticleDOI
A frailty index predicts survival and incident multimorbidity independent of markers of HIV disease severity.
Giovanni Guaraldi,Stefano Zona,Chiara Stentarelli,Federica Carli,Andrea Malagoli,Antonella Santoro,Marianna Menozzi,Chiara Mussi,Cristina Mussini,Susan Kirkland,Julian Falutz,Kenneth Rockwood +11 more
TLDR
Among people aging with HIV in northern Italy, a frailty index based on deficit accumulation predicted survival and incident multimorbidity independently of HIV-related and behavioral risk factors.Abstract:
Objectives Aging with HIV is associated with multisystem vulnerability that might be well characterized by frailty. We sought to construct a frailty index based on health deficit accumulation in a large HIV clinical cohort and evaluate its validity including the ability to predict mortality and incident multimorbidity. Design and methods This is an analysis of data from the prospective Modena HIV Metabolic Clinic cohort, 2004-2014. Routine health variables were screened for potential inclusion in a frailty index. Content, construct, and criterion validity of the frailty index were assessed. Multivariable regression models were built to investigate the ability of the frailty index to predict survival and incident multimorbidity (at least two chronic disease diagnoses) after adjusting for known HIV-related and behavioral factors. Results Two thousand, seven hundred and twenty participants (mean age 46 ± 8; 32% women) provided 9784 study visits; 37 non-HIV-related variables were included in a frailty index. The frailty index exhibited expected characteristics and met validation criteria. Predictors of survival were frailty index (0.1 increment, adjusted hazard ratio 1.63, 95% confidence interval 1.05-2.52), current CD4 cell count (0.48, 0.32-0.72), and injection drug use (2.51, 1.16-5.44). Predictors of incident multimorbidity were frailty index (adjusted incident rate ratio 1.98, 1.65-2.36), age (1.07, 1.05-1.09), female sex (0.61, 0.40-0.91), and current CD4 cell count (0.71, 0.59-0.85). Conclusion Among people aging with HIV in northern Italy, a frailty index based on deficit accumulation predicted survival and incident multimorbidity independently of HIV-related and behavioral risk factors. The frailty index holds potential value in quantifying vulnerability among people aging with HIV.read more
Citations
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Journal ArticleDOI
Frailty and multimorbidity: a systematic review and meta-analysis
Davide L. Vetrano,Davide L. Vetrano,Katie Palmer,Alessandra Marengoni,Emanuele Marzetti,Fabrizia Lattanzio,Regina Roller-Wirnsberger,Luz M. López Samaniego,Leocadio Rodríguez-Mañas,Roberto Bernabei,Graziano Onder +10 more
TL;DR: The three longitudinal studies suggest a bidirectional association between multimorbidity and frailty, which is not conclusive regarding the causal association between the two conditions.
Journal ArticleDOI
Frailty in Older Persons.
TL;DR: Frailty should be considered a condition of major interest for public health and become the lever for reshaping the obsolete health care systems currently unable to adequately address the clinical needs of aging populations.
Journal ArticleDOI
Ageing and inflammation in patients with HIV infection
Milena Nasi,S. De Biasi,Lara Gibellini,Elena Bianchini,Simone Pecorini,V Bacca,Giovanni Guaraldi,Cristina Mussini,Marcello Pinti,Andrea Cossarizza +9 more
TL;DR: The role of inflammation and immune activation on the most important non‐AIDS‐related complications of chronic HIV infection, and the contribution of aging per se to this scenario are discussed.
Journal ArticleDOI
HIV infection is independently associated with frailty in middle-aged HIV type 1-infected individuals compared with similar but uninfected controls.
Katherine W. Kooij,Ferdinand W. N. M. Wit,Judith Schouten,Marc van der Valk,Mieke H. Godfried,Ineke G. Stolte,Maria Prins,Julian Falutz,Peter Reiss +8 more
TL;DR: HIV infection was independently associated with prefrailty/frailty in middle-aged HIV-infected patients compared with HIV-uninfected controls, and may be mediated by the higher waist- and lower hip-circumference in the HIV- infected individuals, and in part be a consequence of historic weight loss associated with advanced HIV-disease.
Journal ArticleDOI
Aging, frailty and complex networks
TL;DR: This model shows how age-dependent acceleration of the FI and of mortality emerges, even without specifying an age-damage relationship or any other time-dependent parameter, and supports the idea that aging occurs as an emergent phenomenon, and not as a result of age-specific programming.
References
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Journal Article
Cardiovascular Health Study Collaborative Research Group : Frailty in older adults : evidence for a phenotype
Journal ArticleDOI
Frailty in elderly people
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