Nearly one in five older people living with HIV showed signs of frailty in a recent Canadian study, and being single or lonely increased the odds. Frailty is a common syndrome among older adults that carries an increased risk for poor health outcomes, including falls, cognitive impairment, disability, hospitalization and death.

 

Alice Zhabokritsky, MD, of the University Health Network in Toronto, and colleagues assessed the prevalence of frailty and associated risk factors among 439 HIV-positive people ages 65 and older who were on effective antiretroviral therapy. In particular, they looked at the link between frailty and nadir (lowest-ever) CD4 T-cell count, noting that persistent immune dysregulation and chronic inflammation seem to play an important role in the development of frailty.

 

Frailty was assessed using a metric that includes unintentional weight loss, exhaustion, poor grip strength, slow walking speed and low physical activity. The overall prevalence of frailty was 16.6%—more than double the rate seen in a previous study of HIV-negative Canadians in the same age group. The likelihood of frailty increased with age, and women had a slightly higher prevalence than men.

 

Contrary to their hypothesis, the researchers did not see an increase in frailty among people with a lower nadir CD4 count. However, people who had higher scores on a loneliness scale had a 25% greater likelihood of frailty, and those who were not married or partnered had about double the risk.

 

“While nadir CD4 count did not correlate with frailty, being single and lonely did, highlighting the importance of recognizing and addressing these social vulnerabilities among people aging with HIV,” the study authors concluded.