BACKGROUND:
Nutritional
status and food insecurity are associated with frailty in the general U.S.
population, yet little is known about this in the aging population of people
living with HIV (PLWH).
OBJECTIVES:
Given
the potential importance of nutrition and the amenability to intervention, we
examined the association between nutritional status, food insecurity, and
frailty in PLWH.
PARTICIPANTS:
50
PLWH, age ≥45 years, recruited from a cohort study examining risk factors for
cardiovascular disease.
MEASUREMENTS:
Frailty,
duration of HIV, use of antiretroviral therapy, disease history, food
insecurity, physical function, and physical activity were assessed by
questionnaire. Dietary intake was assessed using 3-day food records. Blood was
drawn for CD4+ cell count, hemoglobin, hematocrit, and lipid levels. Physical
measurements included height, weight, and skinfold thickness.
RESULTS:
The
prevalence of frailty was 16% (n=8), 44% were pre-frail (n=22) and 40% were not
frail (n=20). The number of reported difficulties with 20 activities of daily
living was highest in frail (mean 10.4±3.9 SD), followed by pre-frail
(6.5±4.6), and lowest in not frail participants (2.0±2.3). Seven (88%) of the
frail PLWH lost weight with an average weight loss of 22.9 pounds; 6 (75%)
reported unintentional weight loss, and all 6 of these met the frailty criteria
for weight loss of 10 or more pounds. Nine (45%) of the not frail PLWH reported
losing weight with an average weight loss of 6.2 pounds; 5 (23%) reported
unintentional weight loss of <10 pounds. Frail PLWH were more likely to
report being food insecure than not frail PLWH (63% vs. 10%, p=0.02), and
tended to have lower energy intake than not frail PLWH.
CONCLUSION:
Research
is needed on targeted interventions to improve food security and activities of
daily living in PLWH for both the prevention and improvement of frailty.
Below: Weight loss by frailty status
1School of Biological and Population Health
Sciences, Oregon State University, Corvallis, OR, USA
2Department of Public Health and Community
Medicine, Tufts School of Medicine, Boston, MA, USA.
Corresponding author: Ellen Smit; School of Biological and
Population Health Sciences, Oregon State University, Milam 135, Corvallis, OR
97331, USA. Phone: +1 (541) 737-3833; Email: ude.etatsnogero@timS.nellE
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