Association of Age and Comorbidity with Physical Function in HIV-Infected and Uninfected Patients: Results from the Veterans Aging Cohort Study

Departement of Medicine, University of Maryland School of Medicine, Veterans Affairs Maryland Healthcare System, Baltimore, Maryland 21201-1524, USA.
AIDS patient care and STDs (Impact Factor: 3.5). 01/2011; 25(1):13-20. DOI: 10.1089/apc.2010.0242
Source: PubMed


HIV clinical care now involves prevention and treatment of age-associated comorbidity. Although physical function is an established correlate to comorbidity in older adults without HIV infection, its role in aging of HIV-infected adults is not well understood. To investigate this question we conducted cross-sectional analyses including linear regression models of physical function in 3227 HIV-infected and 3240 uninfected patients enrolled 2002-2006 in the Veterans Aging Cohort Study-8-site (VACS-8). Baseline self-reported physical function correlated with the Short Form-12 physical subscale (ρ = 0.74, p < 0.001), and predicted survival. Across the age groups decline in physical function per year was greater in HIV-infected patients (β(coef) -0.25, p < 0.001) compared to uninfected patients (β(coef) -0.08, p = 0.03). This difference, although statistically significant (p < 0.01), was small. Function in the average 50-year old HIV-infected subject was equivalent to the average 51.5-year-old uninfected subject. History of cardiovascular disease was a significant predictor of poor function, but the effect was similar across groups. Chronic pulmonary disease had a differential effect on function by HIV status (Δβ(coef) -3.5, p = 0.03). A 50-year-old HIV-infected subject with chronic pulmonary disease had the equivalent level of function as a 68.1-year-old uninfected subject with chronic pulmonary disease. We conclude that age-associated comorbidity affects physical function in HIV-infected patients, and may modify the effect of aging. Longitudinal research with markers of disease severity is needed to investigate loss of physical function with aging, and to develop age-specific HIV care guidelines.

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Available from: Kris Ann Oursler, Aug 03, 2015
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    • "Previous studies comparing the prevalence of comorbidities between HIV-infected and HIV-uninfected individuals showed discrepant results, however. The prospective cross-sectional study by Onen et al showed that HIV-infected patients in the US had a higher prevalence of hypertension and hypertriglyceridemia than HIV-uninfected individuals [18], while the VACS study by Oursler et al showed that HIV-uninfected individuals in the US had a higher prevalence of hypertension and diabetes mellitus than HIV-infected patients [12]. "
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