. A new frailty syndrome: central obesity and frailty in older adults with the human immunodeficiency virus.
Open accessAbstract
OBJECTIVES: To evaluate the relationships between body composition and physical frailty in community-dwelling older adults with the human immunodeficiency virus (HIV) (HOA). DESIGN: Cross-sectional. SETTING: Academic hospital-based infectious disease clinic in Rochester, New York. PARTICIPANTS: 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/m(2), mean CD4 count of 569 cells/mL, and a mean duration since HIV diagnosis of 17 years; 28% were female and 57% Caucasian. MEASUREMENTS: 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). RESULTS: 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. CONCLUSION: 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.
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- Authors
- Shah, K., Hilton, T. N., Myers, L., Pinto, J. F., Luque, A. E., & Hall, W. J.
- Affiliations
- Highland Hospital (US)
- Ithaca College (US)
- University of Rochester Medicine (US)
- Corresponding author
- Shah, Krupa
- Venue
- Journal of the American Geriatrics Society
- Publisher
- Wiley
- Published
- 2012-02-08
- Volume
- 60
- Issue
- 3
- Pages
- 545-549
- ISSN
- 0002-8614 (ISSN-L)
- 1532-5415
- PMC
- PMC3302930
- OpenAlex
- W2020759754
- Cited by
- 77
- References
- 30
- Citations by year
- 2026: 1 · 2025: 3 · 2024: 3 · 2023: 2 · 2022: 2 · 2021: 1 · 2020: 3 · 2019: 5 · 2018: 4 · 2017: 5 · 2016: 11 · 2015: 12 · 2014: 10 · 2013: 11 · 2012: 4
- FWCI
- 13.16
- Type
- journal article
- Language
- en
- Open access
- green
- europepmc.org
- Locations
- Journal of the American Geriatrics Society (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Digital Collections - Ithaca College Library (Ithaca College) (submittedVersion, public-domain)
- Funders
- John A. Hartford Foundation
- National Institutes of Health
- Medical Center, University of Rochester
- National Institute on Aging (T32AG020493, AG020493)
- National Institute of Allergy and Infectious Diseases (P30 AI78498, P30AI078498)
- National Center for Research Resources (UL1RR024160)
- Topics
- Health Sciences › Medicine › Emergency Medicine › HIV-related health complications and treatments
- Health Sciences › Medicine › Geriatrics and Gerontology › Frailty in Older Adults
- Health Sciences › Medicine › Physiology › Nutrition and Health in Aging
- Keywords
- physical frailty, HIV, older adults, abdominal obesity, lipodystrophy, body composition, fat redistribution, trunk fat, intermuscular fat, functional status, physical performance, walking speed, balance, muscle quality, antiretroviral therapy
- MeSH terms
- Aged, Body Composition, Cross-Sectional Studies, Disability Evaluation, Female, Humans, Magnetic Resonance Imaging, Male, Middle Aged, New York, Surveys and Questionnaires, Absorptiometry, Photon, HIV Infections, Frail Elderly, Statistics, Nonparametric, Obesity, Abdominal
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