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Published, Version of Record (VoR)CC BY V4.0, Open
Journal article
Prognostic Factors of Physical Function Decline Among Middle-Aged Adults With HIV
Open forum infectious diseases, v 12(6), ofaf311
Jun 2025
PMID: 40519631
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Background
Pitavastatin to REduce Physical Function Impairment and FRailty in HIV (PREPARE) found small declines in physical function overall among people with HIV (PWH). However, there was substantial individual variability. The purpose of this pre-specified exploratory analysis was to identify PWH at greatest risk for physical function decline.
Methods
Participant-specific annualized rates of change on annually measured chair rise rate, gait speed, the modified Short Performance Physical Battery (composite of the latter two plus balance time), and grip strength were estimated from linear mixed effect models. Change in performance that was below the 20th percentile of the study population in ≥1 measure was classified as physical function decline. Associations between baseline factors and physical function decline were evaluated with log-binomial regression models.
Results
Of 569 participants (81% male, 52% white), median age was 51 (Q1-Q3: 47-55) years. Half (52%) of the participants had decline in physical function. The risk of decline was higher among females (relative risk: 1.32, 95% confidence interval: 1.12-1.55), non-whites (1.23, 1.05-1.45), and tended to increase with age (1.04, 0.86-1.26 in 50-55 and 1.17, 0.98-1.39 in 55+ vs. 40-<50 years). In models adjusted for age, sex, and race, we found greater risk of decline among those with history of depression treatment, higher body mass index (BMI), pre-existing functional impairment, frailty (by index), and higher baseline hs-CRP and IL-6 levels.
Conclusions
PWH with history of depression treatment, high BMI, or levels of inflammation and those showing early signs of functional impairment may be at higher risk of physical function decline and should be targeted for early interventions to preserve physical function with aging.
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Details
- Title
- Prognostic Factors of Physical Function Decline Among Middle-Aged Adults With HIV
- Creators
- Grace L Kulik (Corresponding Author) - University of Colorado Anschutz Medical CampusTriin Umbleja - Harvard UniversityTodd T Brown - Johns Hopkins MedicineHeather J Ribaudo - Harvard UniversitySteven K Grinspoon - Massachusetts General HospitalJennifer A Schrack - Johns Hopkins UniversityMarkella V Zanni - Massachusetts General HospitalMarissa R Diggs - Massachusetts General HospitalJudith A Aberg - Icahn School of Medicine at Mount SinaiCarl J Fichtenbaum - University of Cincinnati Medical CenterCarlos D Malvestutto - The Ohio State UniversitySarah M Chu - Massachusetts General HospitalJudith S Currier - University of California, Los AngelesPamela S Douglas - Duke UniversityGerald S Bloomfield - Duke UniversityAlice C Thornton - University of KentuckyMichelle A Floris-Moore - University of North Carolina at Chapel HillElliot Goodenough - Drexel UniversityGrant B Ellsworth - Cornell UniversityTricia Burdo - Temple UniversityKristine M Erlandson - University of Colorado Anschutz Medical Campus
- Publication Details
- Open forum infectious diseases, v 12(6), ofaf311
- Publisher
- Oxford University Press
- Number of pages
- 11
- Grant note
- National Institutes of HealthACTG Clinical Trials SpecialistsCenter for Biostatistics in AIDS Research
Acknowledgments. The study investigators thank the study participants, site staff, and study-associated personnel for their ongoing participation in the trial. In addition, we thank the following: the ACTG for clinical site support; ACTG Clinical Trials Specialists (Laura Moran, MPH, and Jhoanna Roa, MD) for protocol development and implementation support; the data management center, Frontier Science Foundation, for data support; the Center for Biostatistics in AIDS Research for statistical support; and the Community Advisory Board for input for the community.
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Infectious Diseases (and HIV Medicine)
- Web of Science ID
- WOS:001507706100001
- Scopus ID
- 2-s2.0-105009064806
- Other Identifier
- 991022054297304721
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InCites Highlights
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Immunology
- Infectious Diseases
- Microbiology