Document Detail


Risk factors for falls in HIV-infected persons.
MedLine Citation:
PMID:  23143526     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The incidence of and risk factors for falls in HIV-1-infected persons are unknown.
METHODS: Fall history during the prior 12 months, medical diagnoses, and functional assessments were collected on HIV-infected persons 45-65 years of age receiving effective antiretroviral therapy. Fall risk was evaluated using univariate and multivariate regression analyses.
RESULTS: Of 359 subjects, 250 persons (70%) reported no falls, 109 (30%) had ≥1 fall; and 66 (18%) were recurrent fallers. Females, whites, and smokers were more likely to be recurrent fallers (P ≤ 0.05). HIV-related characteristics including current and nadir CD4 T-cell count, estimated HIV duration, and Veterans Aging Cohort Study Index scores were not predictors of falls (all P ≥ 0.09); didanosine recipients were more likely to be recurrent fallers (P = 0.04). The odds of falling increased 1.7 for each comorbidity and 1.4 for each medication (P < 0.001) and were higher in persons with cardiovascular disease, hypertension, dementia, neuropathy, arthritis, chronic pain, psychiatric disease, frailty, or disability [all odds ratio (OR) ≥ 1.8; P ≤ 0.05]. Beta-blockers, antidepressants, antipsychotics, sedatives, and opiates were independently associated with falling (all OR ≥ 2.7; P ≤ 0.01). Female gender, diabetes, antidepressants, sedatives, opiates, didanosine, exhaustion, weight loss, and difficulty with balance were the most significant predictors of falls in logistic regression (all OR ≥ 2.5; P ≤ 0.05).
CONCLUSIONS: Middle-aged HIV-infected adults have high fall risk. Multiple comorbidities, medications, and functional impairment were predictive of falls, but surrogate markers of HIV infection or an HIV-specific multimorbidity index were not. Fall risk should be assessed routinely as part of the care of HIV-infected persons.
Authors:
Kristine M Erlandson; Amanda A Allshouse; Catherine M Jankowski; Syki Duong; Samantha MaWhinney; Wendy M Kohrt; Thomas B Campbell
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of acquired immune deficiency syndromes (1999)     Volume:  61     ISSN:  1944-7884     ISO Abbreviation:  J. Acquir. Immune Defic. Syndr.     Publication Date:  2012 Dec 
Date Detail:
Created Date:  2012-11-12     Completed Date:  2013-01-23     Revised Date:  2014-03-19    
Medline Journal Info:
Nlm Unique ID:  100892005     Medline TA:  J Acquir Immune Defic Syndr     Country:  United States    
Other Details:
Languages:  eng     Pagination:  484-9     Citation Subset:  IM; X    
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MeSH Terms
Descriptor/Qualifier:
Accidental Falls / statistics & numerical data*
Aged
Anti-HIV Agents / administration & dosage
Female
HIV Infections / complications*,  drug therapy,  virology
HIV-1 / isolation & purification
Humans
Incidence
Male
Middle Aged
Risk Factors
Grant Support
ID/Acronym/Agency:
T32 AI007447/AI/NIAID NIH HHS; T32 AI007447/AI/NIAID NIH HHS; UL1 RR025780/RR/NCRR NIH HHS; UL1 TR000154/TR/NCATS NIH HHS
Chemical
Reg. No./Substance:
0/Anti-HIV Agents
Comments/Corrections

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