@article{52b94cbfd8044c208eaf2352e6ba1d97,
title = "Frailty predicts fractures among women with and at-risk for HIV",
abstract = "To determine associations between frailty and fracture in women with and without HIV infection.Design:Prospective longitudinal cohort study evaluating associations between baseline frailty status and frailty components, with first and second incident fractures.Methods:We evaluated associations of frailty with fracture among 1332 women with HIV and 532 uninfected women without HIV. Frailty was defined as at least three of five Fried Frailty Index components: slow gait, reduced grip strength, exhaustion, unintentional weight loss, and low physical activity. Cox proportional hazards models determined predictors of time to first and second fracture; similar models evaluated Fried Frailty Index components.Results:Women with HIV were older (median 42 vs. 39 years, P<0.0001) and more often frail (14 vs. 8%, P=0.04) than women without HIV; median follow-up was 10.6 years. Frailty was independently associated with time to first fracture in women with and without HIV combined [adjusted hazard ratio (aHR) 1.71, 95% confidence interval (CI): 1.30-2.26; P=0.0001], and among women with HIV only (aHR 1.91, 95% CI: 1.41-2.58; P<0.0001), as well as with time from first to second fracture among women with HIV (aHR 1.86, 95% CI: 1.15-3.01; P=0.01).Conclusion:In this cohort of middle-aged racial and ethnic minority women with or at-risk for HIV, frailty was a strong and independent predictor of fracture risk. As women with HIV continue to age, early frailty screening may be a useful clinical tool to help identify those at greatest risk of fracture.",
keywords = "HIV, aging, fracture, frailty, women",
author = "Anjali Sharma and Qiuhu Shi and Hoover, {Donald R.} and Tien, {Phyllis C.} and Plankey, {Michael W.} and Cohen, {Mardge H.} and Golub, {Elizabeth T.} and Deborah Gustafson and Yin, {Michael T.}",
note = "Funding Information: Data in this article were collected by the Women{\textquoteright}s Interagency HIV Study (WIHS). The contents of this publication are solely the responsibility of the authors and do not represent the official views of the National Institutes of Health (NIH). Data in this article were collected by five sites of the Women{\textquoteright}s Interagency HIV Study (WIHS). WIHS (Principal Investigators): Bronx WIHS (Kathryn Anastos), U01-AI-035004; Brooklyn WIHS (Howard Minkoff and D.G.), U01-AI-031834; Chicago WIHS (M.H.C. and Audrey French), U01-AI-034993; Metropolitan Washington WIHS (Seble Kas-saye), U01-AI-034994; Connie Wofsy Women{\textquoteright}s HIV Study, Northern California (Ruth Greenblatt, Bradley Aouizerat, and P.C.T.), U01-AI-034989; WIHS Data Management and Analysis Center (Stephen Gange and E.T.G.), U01-AI-042590. The WIHS is funded primarily by the National Institute of Allergy and Infectious Diseases (NIAID), with additional cofunding from the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), the National Cancer Institute (NCI), the National Institute on Drug Abuse (NIDA), and the National Institute on Mental Health (NIMH). Contents of this publication are solely the responsibility of the authors and do not necessarily represent the official views of the National Institutes of Health. This research was also supported by National Institutes of Health K23AR06199301 (A.S.). Publisher Copyright: {\textcopyright} 2019 Wolters Kluwer Health, Inc. All rights reserved.",
year = "2019",
month = mar,
day = "1",
doi = "10.1097/QAD.0000000000002082",
language = "English (US)",
volume = "33",
pages = "455--463",
journal = "AIDS",
issn = "0269-9370",
publisher = "Lippincott Williams and Wilkins",
number = "3",
}