URBAN ARCH (5/5) Boston Cohort - Alcohol and HIV-associated comorbidity and complications: Frailty, Functional impairment, Falls, and Fractures (the 4F study)

URBAN ARCH (5/5) 波士顿队列 - 酒精和 HIV 相关合并症和并发症：虚弱、功能障碍、跌倒和骨折（4F 研究）

• 批准号: 10425888
• 负责人: Timothy C. Heeren
• 金额: $ 16.13万
• 依托单位: BOSTON UNIVERSITY MEDICAL CAMPUS
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-09-20 至 2023-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10425888
• 关键词: AIDS/HIV problem; Accident and Emergency department; Acute; Address; Affect; Age; Aging; Alcohol consumption; Alcohols; Body Weight decreased; Boston; Cessation of life; Clinical; Cohort Studies; Collaborations; Complication; Development; Disease; Drug usage; Elderly; Emergency department visit; Fall prevention; Fracture; HIV; HIV Infections; HIV risk; Hepatitis C co-infection; High Prevalence; Hospitalization; Illicit Drugs; Impairment; Inflammation; Injury; Intervention; Intervention Studies; Knowledge; Lead; Mediating; Mediation; Morbidity - disease rate; Nature; Neuropathy; Opioid; Osteopenia; Osteoporosis; Osteoporotic; Outcome; Pharmaceutical Preparations; Phenotype; Physical Function; Play; Polypharmacy; Population; Premature aging syndrome; Recovery; Research; Research Priority; Risk; Risk Factors; Role; Russia; Substance Use Disorder; Testing; Translating; Uganda; United States National Institutes of Health; Viremia; Walking; alcohol and other drug; alcohol consequences; alcohol exposure; alcohol research; antiretroviral therapy; base; cohort; comorbidity; cost; efficacious intervention; exhaustion; experience; fall risk; falls; feasibility testing; frailty; functional disability; grasp; health care service utilization; high risk; illicit drug use; improved outcome; inflammatory marker; microbial; middle age; mortality; prevent; preventive intervention; substance use; systematic review; therapy development; virology

Up to a third of middle-aged people living with HIV infection (PLWH) experience falls each year. Falls are the most common cause of non-fatal injury in the US and the cost from emergency department visits and hospitalizations are enormous. PLWH are more susceptible to falls and their serious consequences because 1) despite control of HIV viremia, inflammation persists and underlies HIV-associated comorbidities and complications that occur at a relatively young age (so-called premature aging), 2) specific comorbidities (e.g. neuropathy, osteoporosis) and complications (e.g. frailty and impaired physical function) make falls more likely and recovery from them more difficult, 3) alcohol use exacerbates inflammation, and may increase risk for comorbidities and complications, and 4) alcohol use, illicit drug use and polypharmacy can increase the likelihood of a fall. Despite this, fall prevention has not been extensively studied among PLWH. We need interventions to address falls in PLWH but none have been tailored for this population. Understanding risk factors and targets for intervention among PLWH are essential; cohort studies can provide the information needed for intervention development. This proposal is part the Consortia for HIV/AIDS and Alcohol-Related Research Trials (CHAART). It describes the continuation and expansion of a cohort that is one of three in the Uganda Russia Boston Alcohol Network for Alcohol Research Collaboration on HIV/AIDS (URBAN ARCH). The URBAN ARCH theme is to address consequences of alcohol use on HIV-associated comorbidities and complications to increase treatment availability and improve outcomes. In line with that theme we propose to continue to follow and expand (to 400) an existing cohort of PLWH and a high prevalence of exposure to alcohol, illicit drugs, and polypharmacy (the Boston ARCH Cohort) in the Frailty, Functional impairment, Falls, and Fractures (4F study) to: (in 2 Primary Aims) 1) Test the associations between alcohol (and illicit drugs and polypharmacy) and falls (fractures secondarily); and 2) Test the associations between alcohol (and illicit drugs and polypharmacy) and acute healthcare utilization (emergency department use and hospitalization for falls and fractures). We will also examine the role frailty plays in these associations between alcohol, drugs and medications and the aforementioned clinical and utilization outcomes. In Exploratory Aims we will test associations between alcohol use and inflammatory markers, and between markers and HIV-associated complication outcomes (4Fs); and develop and pilot test the feasibility of a falls prevention intervention tailored to address the identified risk factors (e.g. alcohol, illicit drugs, polypharmacy) in this population. By achieving these aims we will gain substantially greater understanding of these comorbidities and complications in PLWH exposed to alcohol and other psychoactive substances; this knowledge will serve to inform the development of ways to identify, prevent and manage falls, fractures, frailty and functional impairment.

每年有多达三分之一的中年艾滋病毒感染者（PLWH）经历跌倒。瀑布

项目成果

Study Protocol for a Pilot Randomized Trial of a Virtual Occupational Therapy Fall Prevention Intervention for People With HIV and Alcohol Use.

针对艾滋病毒和酗酒者的虚拟职业治疗跌倒预防干预的试点随机试验研究方案。

• DOI: 10.1177/11782218221145548
• 发表时间: 2022
• 期刊: SUBSTANCE ABUSE-RESEARCH AND TREATMENT
• 影响因子: 2.1
• 作者: Shin, Danny;Gill, Simone, V;Kim, Theresa W.;Magane, Kara M.;Mason, Tiana;Heeren, Timothy;Winter, Michael;Helfrich, Christine;Saitz, Richard
• 通讯作者: Saitz, Richard

Identification of non-steroidal anti-inflammatory drug use disorder: A case report.

• DOI: 10.1016/j.addbeh.2017.02.008
• 发表时间: 2017-07
• 期刊: Addictive behaviors
• 影响因子: 4.4
• 作者: Godersky ME;Vercammen LK;Ventura AS;Walley AY;Saitz R
• 通讯作者: Saitz R