Frailty predicts fractures among women with and at-risk for HIV

Anjali Sharma, Qiuhu Shi, Donald R. Hoover, Phyllis C. Tien, Michael W. Plankey, Mardge H. Cohen, Elizabeth T. Golub, Deborah Gustafson, Michael T. Yin

Research output: Contribution to journalArticlepeer-review

4 Scopus citations


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.

Original languageEnglish (US)
Pages (from-to)455-463
Number of pages9
Issue number3
StatePublished - Mar 1 2019


  • HIV
  • aging
  • fracture
  • frailty
  • women

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology
  • Infectious Diseases


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