Do Geriatric Conditions Occur Early in HIV-Positive Men?
Getting older can give rise to a host of conditions. According to a study of HIV-positive adults in a San Francisco clinic, middle-aged HIV-positive men developed "geriatric" symptoms at a much younger age than did the general population. They experienced difficulties with daily activities, cognitive impairment and urinary incontinence at equal or higher rates to HIV-negative men in an over-65 community, even though their median age was just 57, reports aidsmap.com.
While improved antiretroviral therapy has made a normal life expectancy possible for people living with HIV, it means that researchers must work diligently to find out how HIV interacts with common age-related comorbidities (additional illnesses or medical challenges), including cardiovascular disease and low bone mineral density.
Researchers are especially interested in finding out how frailty, falls and functional impairment affect people with HIV, because these multifactorial conditions are little-studied in HIV-positive populations. These factors are important in identifying vulnerable older adults.
The study authors emphasized that people living with HIV should also seek clinical care for the geriatric symptoms seen in their research.
On average, participants had been living with HIV for 21 years and had a median CD4 count over 500. Fifty-four percent of patients had two or more geriatric syndromes, the most common being "pre-frailty" (a combination of factors such as unintentional weight loss, low physical activity level, weakness, exhaustion and slow walking speed), and impairments in functioning and thinking. Twenty percent of patients reported mild depression and another 18% met criteria for moderate-to-severe depression.
Ultimately, the authors found that these conditions were most affected by CD4 nadir -- how low were the patients' lowest CD4 count, not their current CD4 count -- and the number of comorbidities.
Researchers said the results pointed to an even greater emphasis on early antiretroviral treatment to prevent aging-related complications, and that retention in care and monitoring of HIV-positive people is of the utmost importance.
"Consideration of how to incorporate assessment of geriatric syndromes into HIV care and development of targeted interventions for risk factors of geriatric syndromes is needed as the HIV-infected population continues to age," the authors concluded, as reported by aidsmap.com.
To read more about HIV and aging, visit TheBody.com's Resource Center on Aging With HIV.