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COPD Associated With Frailty in HIV-Infected Veterans

by U.S. Medicine

January 21, 2017

WEST HAVEN, CT—With chronic obstructive pulmonary disease (COPD) prevalence increasing among aging HIV-infected patients, a recent study sought to determine how that relates to frailty in veterans treated at the VA.

The study, published in the journal AIDS, determined the association between COPD and self-reported measures of frailty—adapted frailty-related phenotype (aFRP) —and physical limitation, and a clinical biomarker of physiologic frailty from the [Veterans Aging Cohort Study (VACS) Index in HIV-infected veterans, comparing them with uninfected counterparts.1

For cross-sectional study of VACS participants between 2002 and 2012, researchers from the VA Connecticut Healthcare System obtained pre-frail/aFRP from self-reported surveys, defining the condition as one or two domains of physical shrinking, exhaustion, slowness and low physical activity. At the same time, aFRP was defined as at least three domains.

Physical limitation scale was determined from 12 self-reported survey items assessing limitations performing physical activities. The VACS index, meanwhile, includes age and laboratory measurements.

Included in the study were 3,538 HIV-infected and 3,606 uninfected participants, mostly men and majority (67% and 63%, respectively) black. Of the HIV-infected group, 4% had COPD, as did 5% of the control.

Results indicate that COPD was associated with increased pre-frail and aFRP in HIV-infected and uninfected participants. COPD also was associated with physical limitation in both groups.

“There was an interaction between COPD and physical limitation by HIV status with increased physical limitation among HIV-infected participants (P = 0.04),” according to the researchers, who add that COPD was not associated with VACS index.

“COPD was strongly associated with aFRP and physical limitations,” study authors note. “COPD management may mediate frailty through functional limitations rather than physiologic biomarkers, especially in HIV-infected individuals.”

  1. Akgün KM, Tate JP, Oursler KK, Crystal S, Leaf DA, Womack JA, Brown TT, Justice AC, Crothers K. Association of chronic obstructive pulmonary disease with frailty measurements in HIV-infected and uninfected Veterans. AIDS. 2016 Sep 10;30(14):2185-93. doi: 10.1097/QAD.0000000000001162. PubMed PMID: 27191979.

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