An Emerging Concern—High Rates of Frailty among Middle-aged and Older Individuals Living with HIV

Jacqueline M. McMillan, Hartmut B. Krentz, M. John Gill, David B. Hogan


The aim of the present study was to calculate a frailty index (FI) in older adults (≥50) living with HIV, search for cross-sectional associations with the FI, and investigate the association between the FI score and two-year mortality.

Cross-sectional study with a short-term prospective com-ponent for the determination of two-year mortality was performed. The study took place in an HIV outpatient clinic in Calgary, Canada between November 1, 2016 and December 31, 2018. Over 700 patients 50 years of age or older took part. We calculated a FI for each patient, examined associations between FI and select patient characteristics, and evaluated the association between FI value and two-year mortality.

The mean FI was 0.303 (± 0.128). Mean FI did not differ between males and females, nor was it associated with either nadir or current CD4 cell count. It did increase with age, duration of ART, and duration of diagnosed HIV infection. Mean FI was higher among those who died compared to survivors (0.351 vs. 0.301; p=.033).

Frailty is highly prevalent in persons living with HIV and associated with a higher mortality rate. Health-care providers should be aware of the earlier occurrence of frailty in adults living with HIV.


frailty; frailty index; human immunodeficiency virus (HIV); geriatric syndrome; vulnerability; anti-retroviral therapy; accelerated aging; multimorbidity

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ISSN: 1925-8348 (Online)