Geriatric Syndromes in Older HIV-Infected Adults
As the HIV-infected population ages, it is critical to understand how geriatric principles can be applied to improve outcomes and quality of life for older HIV-infected adults. Geriatric syndromes, which include falls, incontinence, and cognitive impairment, are a fundamental construct in gerontology. These syndromes are the result of deficits in multiple organ systems, as well as psychosocial and environmental vulnerabilities. Given the multiple organ derangements and complicated social and environmental factors associated with HIV infection and its treatment, geriatric syndromes are a relevant paradigm to study in older HIV-infected adults and can serve as a tool to determine which patients are at highest risk for complications associated with aging. Limited data exists on these syndromes in this population and no comprehensive assessment of geriatric syndromes in older HIV-infected adults has been reported. We propose a cross-sectional study with the primary objectives to 1) characterize the frequencies of common geriatric syndromes in an older HIV-infected population and 2) identify both HIV and non-HIV related factors associated with the presence of geriatric syndromes. This proposed study will draw from the strengths of the existing CFAR-supported Study of the Consequences of the Protease Inhibitor Era (SCOPE) cohort. During a six-month timeframe, we will evaluate 200 SCOPE participants age 50 and older who have an undetectable plasma HIV RNA level on antiretroviral therapy. We will describe the frequency of each syndrome and use bivariate and multivariate analyses to explore which HIV and non-HIV-related factors may be associated with the presence of these syndromes to develop testable hypotheses for future work. By delineating the potential role of geriatric syndromes in older HIV infected adults, this proposed study will provide an important framework for future studies focused on prevention of complications of aging and outcomes associated with geriatric syndromes.