Association of comorbidity with physical disability in older HIV-infected adults
Association of comorbidity with physical disability in older HIV-infected adults
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DOI：
10.1089/apc.2006.20.782
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发表时间：
2006-11-01
影响因子：
4.9
通讯作者：
Crystal, Stephen
中科院分区：
文献类型：
--
作者：
Oursler, Krisann K.;Goulet, Joseph L.;Crystal, Stephen
随着 50 岁以上感染者数量的增加，合并症、衰老及其对身体功能的影响将在艾滋病毒医疗保健中发挥越来越大的作用。该研究的目的是调查艾滋病毒感染者和艾滋病毒阴性患者的合并症和年龄与身体功能的关系。该研究纳入了 2001 年 9 月至 2002 年 6 月期间进行的退伍军人老龄化队列研究中的 889 名艾滋病毒感染退伍军人和 647 名艾滋病毒阴性退伍军人。身体机能是通过自我报告的各种身体活动的困难来衡量的。进行回归分析以检查与身体功能相关的人口统计和临床因素。由于艾滋病毒感染者和艾滋病毒阴性受试者的人口构成不同，因此使用了单独的模型。在两个患者组中，慢性肺病、冠状动脉疾病、高血压、吸烟和重度抑郁症与年龄和种族调整回归模型中的身体机能下降独立相关。对于艾滋病毒感染者和艾滋病毒阴性患者来说，年龄的增长与身体机能的下降有关。然而，当将艾滋病毒感染者和艾滋病毒阴性患者的共病纳入模型时，年龄系数降低并且不再具有统计显着性。在艾滋病毒感染者中，在控制抗逆转录病毒治疗和艾滋病毒疾病阶段的影响后，结果保持不变。我们的研究结果表明，一般医疗合并症对 HIV 感染者和 HIV 阴性患者的身体功能具有重要作用。这表明有效治疗艾滋病毒感染者合并症的重要性，以减少疾病对身体功能的总体影响。
Comorbidity, aging, and their impact on physical functioning will play an increasingly greater role in HIV medical care as the number of infected adults over 50 years of age grows. The study objective was to investigate the relationship of comorbidity and age with physical functioning in HIV-infected and HIV-negative patients. Eight hundred eighty-nine HIV-infected veterans and 647 HIV-negative veterans from the Veterans Aging Cohort Study conducted between September 2001 and June 2002 were included in the study. Physical functioning was measured by self-reported difficulty with various physical activities. Regression analyses were performed to examine demographic and clinical factors associated with physical functioning. Separate models were used for HIV-infected and HIV negative subjects since these groups differed in demographic makeup. In both patient groups, chronic lung disease, coronary artery disease, hypertension, smoking, and major depression were independently associated with reduced physical functioning in age and race adjusted regression models. Increased age was associated with reduced physical functioning in both HIV-infected and HIV-negative patients. However, when comorbid conditions were entered into the models for both HIV-infected and HIV-negative patients, age coefficients were reduced and were no longer statistically significant. Among the HIV-infected patients, results remained unchanged after controlling for the impact of antiretroviral therapy and HIV disease stage. Our findings demonstrate the important role of general medical comorbidity in physical functioning in both HIV-infected and HIV-negative patients. This suggests the importance of effectively treating comorbid conditions in persons with HIV, in order to reduce the overall impact of disease on physical functioning.