A New Frailty Syndrome: Central Obesity and Frailty in Older Adults with the Human Immunodeficiency Virus
Version of Record online: 8 FEB 2012
© 2012, Copyright the Authors Journal compilation © 2012, The American Geriatrics Society
Journal of the American Geriatrics Society
Volume 60, Issue 3, pages 545–549, March 2012
How to Cite
Shah, K., Hilton, T. N., Myers, L., Pinto, J. F., Luque, A. E. and Hall, W. J. (2012), A New Frailty Syndrome: Central Obesity and Frailty in Older Adults with the Human Immunodeficiency Virus. Journal of the American Geriatrics Society, 60: 545–549. doi: 10.1111/j.1532-5415.2011.03819.x
- Issue online: 12 MAR 2012
- Version of Record online: 8 FEB 2012
- National Institutes of Health. Grant Numbers: P30 AI78498, AG020493
- John A. Hartford Foundation Center for Excellence in Geriatric Medicine and Training
- human immunodeficiency virus;
- older adults;
To evaluate the relationships between body composition and physical frailty in community-dwelling older adults with the human immunodeficiency virus (HIV) (HOA).
Academic hospital-based infectious disease clinic in Rochester, New York.
Forty community-dwelling HOA aged 50 and older undergoing antiretroviral therapy who were able to ambulate without assistive devices with a mean age of 58, a mean BMI of 29.0 kg/m2, mean CD4 count of 569 cells/mL, and a mean duration since HIV diagnosis of 17 years; 28% were female and 57% Caucasian.
Subjective and objective measures of functional status were evaluated using the Physical Performance Test (PPT), the graded treadmill test, knee strength, gait speed, balance, and the Functional Status Questionnaire (FSQ). Body composition was evaluated using dual-energy X-ray absorptiometry (DXA) and magnetic resonance imaging (MRI).
Sixty percent (25/40) of the participants met standard criteria for physical frailty. Frail (FR) and nonfrail (NF) participants were comparable in age, sex, CD4 count, and viral load. FR HOA had greater impairments in PPT, peak oxygen uptake, FSQ, walking speed, balance, and muscle quality than NF HOA. FR HOA had a greater body mass index (BMI), fat mass, and truncal fat with lipodystrophy. Moreover, PPT score was inversely related to trunk fat (correlation coefficient (r) = −0.34; P = .04) and ratio of intermuscular fat to total fat (r = −0.60; P = .02) after adjusting for covariates.
HOA represent an emerging cohort of older adults who frequently experience frailty at a much younger age than the general older population. Central obesity and fat redistribution are important predictors of frailty in community-dwelling HOA. These findings suggest that physical frailty in HOA may be amenable to lifestyle interventions, especially exercise and diet therapy.