TY - JOUR
T1 - Gait speed decline is associated with hemoglobin a1c, neurocognitive impairment, and black race in persons with HIV
AU - Masters, Mary Clare
AU - Perez, Jeremiah
AU - Tassiopoulos, Katherine
AU - Andrade, Adriana
AU - Ellis, Ronald
AU - Yang, Jingyan
AU - Brown, Todd T.
AU - Palella, Frank J.
AU - Erlandson, Kristine M.
N1 - Funding Information:
Research reported in this publication was supported by the National Institute of Allergy and Infectious Diseases of the National Institutes of Health under award number UM1 AI068634, UM1 AI068636, UM1 AI106701, and NIAID K24 120834 (to T.T.B), the National Institute of Aging K32 63008845 and R01 AG0504366 (to K.M.E); and National Institute of Diabetes and Digestive and Kidney Diseases T32 DK007169 (to M.C.M.).
Publisher Copyright:
© Copyright 2019, Mary Ann Liebert, Inc.
PY - 2019/11/1
Y1 - 2019/11/1
N2 - Gait speed declines at a faster rate in persons with HIV (PWH) than in the general population but the risk factors associated with this decline are not well understood. In the AIDS Clinical Trials Group (ACTG) A5322 (HAILO, HIV Infection, Aging, and Immune Function Long-term Observational Study), an observational cohort study of PWH ≥40 years of age, those who developed slow gait during the first 3 years of follow-up were compared with persons who maintained normal speed. Associations with demographic and clinical covariates were assessed using multivariable logistic regression. Of 929 participants, 81% were men, 31% Black, and 20% Hispanic. Median age was 51 years [interquartile range (IQR) = 46-56]. At study entry, 92% had plasma HIV RNA <50 copies/mL with median CD4 count 631 cells/mm3 (IQR = 458-840). At study entry, 7% of participants had slow gait, 16% had neurocognitive impairment (NCI), and 12% had diabetes. Over 3 years, 87% maintained normal gait speed, 3% maintained a slow gait, 6% developed a slow gait, and 4% improved from slow to normal gait speed. In multivariable models, hemoglobin A1C (HbA1C) percentage, per one unit increase [odds ratio (OR) = 1.36; 95% confidence interval (CI) = 1.03-1.81; p = .033], NCI (OR = 3.47; 95% CI = 1.57-7.69 p = .002), and black versus white race (OR = 2.45; 95% CI = 1.08-5.59; p = .032) at entry were significantly associated with development of slow gait compared with those maintaining normal gait speed. The association between baseline HbA1C and development of slow gait speed highlights an intervenable target to prevent progression of physical function limitations.
AB - Gait speed declines at a faster rate in persons with HIV (PWH) than in the general population but the risk factors associated with this decline are not well understood. In the AIDS Clinical Trials Group (ACTG) A5322 (HAILO, HIV Infection, Aging, and Immune Function Long-term Observational Study), an observational cohort study of PWH ≥40 years of age, those who developed slow gait during the first 3 years of follow-up were compared with persons who maintained normal speed. Associations with demographic and clinical covariates were assessed using multivariable logistic regression. Of 929 participants, 81% were men, 31% Black, and 20% Hispanic. Median age was 51 years [interquartile range (IQR) = 46-56]. At study entry, 92% had plasma HIV RNA <50 copies/mL with median CD4 count 631 cells/mm3 (IQR = 458-840). At study entry, 7% of participants had slow gait, 16% had neurocognitive impairment (NCI), and 12% had diabetes. Over 3 years, 87% maintained normal gait speed, 3% maintained a slow gait, 6% developed a slow gait, and 4% improved from slow to normal gait speed. In multivariable models, hemoglobin A1C (HbA1C) percentage, per one unit increase [odds ratio (OR) = 1.36; 95% confidence interval (CI) = 1.03-1.81; p = .033], NCI (OR = 3.47; 95% CI = 1.57-7.69 p = .002), and black versus white race (OR = 2.45; 95% CI = 1.08-5.59; p = .032) at entry were significantly associated with development of slow gait compared with those maintaining normal gait speed. The association between baseline HbA1C and development of slow gait speed highlights an intervenable target to prevent progression of physical function limitations.
KW - aging
KW - gait speed
KW - hemoglobin A1C
KW - neurocognitive impairment
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UR - http://www.scopus.com/inward/citedby.url?scp=85075091022&partnerID=8YFLogxK
U2 - 10.1089/aid.2019.0101
DO - 10.1089/aid.2019.0101
M3 - Article
C2 - 31468979
AN - SCOPUS:85075091022
SN - 0889-2229
VL - 35
SP - 1065
EP - 1073
JO - AIDS research and human retroviruses
JF - AIDS research and human retroviruses
IS - 11-12
ER -
