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BACKGROUND: Potent antiretroviral treatment has resulted in near normal life expectancy for people living with HIV. Consequently, there is an increased focus on comorbidities, frailty and quality of life.
METHODS: We assessed and compared the prevalence of frailty, associated factors and relationship with quality of life in older Australian men living with HIV in a cross-sectional study using three frailty measurements. The Frailty Phenotype, Frailty Index, and Edmonton Frail Scale were applied to 93 HIV-infected men aged over 50 years, on antiretroviral therapy. Multivariable ordinal logistic regression was used to analyse the associations of frailty with covariates and quality of life.
RESULTS: The prevalence of frailty was 10.8% (n=10) using the Frailty Phenotype; 22.6% (n=21) using the Frailty Index, and 15.1% (n=14) using the Edmonton Frail Scale. Frailty Phenotype-defined pre-frailty/frailty was associated with pre-1996 ART initiation (OR, 3.56; CI, 1.23-10.36; p=0.020) and depression (OR, 3.74; CI, 1.24-11.27; p=0.019). Osteoporosis, serious non-AIDS events and AIDS were associated with Frailty Index-defined frailty (OR, 4.84, CI, 1.27-18.43, p=0.021; OR, 4.27, CI, 1.25-14.58, p=0.020; OR, 4.62, CI, 1.30-16.45, p=0.018, respectively) and Edmonton Frail Scale-defined frailty (OR, 7.51; CI, 1.55-36.42; p=0.012; OR, 7.71; CI, 1.62-36.75; p=0.010; OR, 8.53; CI, 1.70-42.73; p=0.009, respectively), independent of age, and current CD4+ cell count. Frailty, defined by any of the instruments, was significantly associated with poorer quality of life (p<0.001).
CONCLUSIONS: Identifying frailty is an increasingly important contemporary consideration of HIV care related to ageing and quality of life.