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Iriarte E, Cooley S, Wisch J, Erlandson KM, Ances BM, Jankowski C. Area Deprivation Index and Frailty Among Older People With HIV. J Appl Gerontol 2024:7334648241262658. [PMID: 39025783 DOI: 10.1177/07334648241262658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/20/2024] Open
Abstract
We evaluated the relationship between neighborhood disadvantage (measured by the Area Deprivation Index [ADI]) and frailty. We performed a secondary analysis, pooling cross-sectional data collected from 209 people with HIV (PWH) aged ≥50 years enrolled in studies in Colorado (CO) and Missouri (MO). MO participants (N = 137) had a higher ADI (µ= 70, ơ2 = 25) compared to CO (µ= 32, ơ2 = 15; p < .001). No significant differences in ADI were observed between frailty categories when cohorts were examined either separately or combined; however, when comparing individual frailty criteria, the most apparent differences by neighborhood disadvantage were seen among those with limited physical activity (μ = 67, ơ2 = 28) compared to those without (μ = 55, ơ2 = 29, p = .03). Neighborhood disadvantage was associated with low physical activity but not with overall frailty status. Future research should examine how access to physical activity spaces varies based on ADI, as this could be crucial in preventing frailty.
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Affiliation(s)
- Evelyn Iriarte
- University of Colorado College of Nursing, Anschutz Medical Campus, Aurora, CO, USA
- Pontificia Universidad Católica de Chile School of Nursing, Santiago, Chile
| | - Sarah Cooley
- Washington University in St. Louis, St Louis, MO, USA
| | - Julie Wisch
- Washington University in St. Louis, St Louis, MO, USA
| | - Kristine M Erlandson
- University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, CO, USA
| | - Beau M Ances
- Washington University in St. Louis, St Louis, MO, USA
| | - Catherine Jankowski
- University of Colorado College of Nursing, Anschutz Medical Campus, Aurora, CO, USA
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Iriarte E, Cianelli R, De Santis JP, Alamian A, Castro JG, Matsuda Y, Araya AX. Multidimensional Frailty, Quality of Life and Self-Management in Aging Hispanics Living With HIV. J Appl Gerontol 2024; 43:899-909. [PMID: 38173356 DOI: 10.1177/07334648231211743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2024] Open
Abstract
An observational cross-sectional study was conducted to examine multidimensional frailty and its potential impact on quality of life (QOL) in aging Hispanic people living with HIV (PLWH) and assess the extent to which HIV self-management moderates this association. The sample included 120 Hispanic PLWH aged 50 years and older (M = 59.11; SD = 7.04). The structural equation modeling analyses demonstrated that multidimensional frailty was significantly related to QOL in its two dimensions, physical and mental (p < .001). The relationship between multidimensional frailty and mental and physical QOL remained significant even after controlling for confounders (age and gender). The moderator analyses indicated no statistically significant moderator effect of HIV self-management on multidimensional frailty and mental or physical QOL. These study results have practical implications that highlight the need for early screening for frailty with a multidimensional focus. Age-appropriate and culturally tailored interventions to prevent or mitigate multidimensional frailty may improve QOL.
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Affiliation(s)
- Evelyn Iriarte
- Pontificia Universidad Católica de Chile, School of Nursing, Santiago, Chile
- University of Colorado Anschutz Medical Campus, College of Nursing, Aurora, CO, USA
- Millennium Institute for Care Research (MICARE) (ICS2019_024), Santiago, Chile
| | - Rosina Cianelli
- University of Miami, School of Nursing and Health Studies, Coral Gables, FL, USA
| | - Joseph P De Santis
- University of Miami, School of Nursing and Health Studies, Coral Gables, FL, USA
| | - Arsham Alamian
- University of Miami, School of Nursing and Health Studies, Coral Gables, FL, USA
| | - Jose G Castro
- University of Miami, Miller School of Medicine, Miami, FL, USA
| | - Yui Matsuda
- University of Miami, School of Nursing and Health Studies, Coral Gables, FL, USA
| | - Alejandra-X Araya
- Millennium Institute for Care Research (MICARE) (ICS2019_024), Santiago, Chile
- Universidad Andres Bello, School of Nursing, Santiago, Chile
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Iriarte E, Cianelli R, De Santis JP, Villegas N, Irarrazabal L, Jankowski C, Provencio-Vasquez E. HIV-Related Stigma and Multidimensional Frailty Among Older Latinos With HIV. HISPANIC HEALTH CARE INTERNATIONAL 2024; 22:99-108. [PMID: 37853706 DOI: 10.1177/15404153231208130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2023]
Abstract
Introduction: Frailty is a geriatric syndrome of increased vulnerability to stressors marked by a higher risk for poor health outcomes. HIV-related stigma is a stressor for Latino people with HIV (PWH) and an important barrier to HIV care. This study examines the association between HIV-related stigma and multidimensional frailty among older Latino PWH. Methods: A cross-sectional design with 120 Latino PWH aged 50 and older was used. Self-reported questionnaires were administered to assess multidimensional frailty (Tilburg Frailty Indicator) and HIV-related stigma (HIV stigma scale). Results: Participants were 59.1 ± 7.0 years old, primarily White-Hispanic (85.00%, n = 102), single (48.33%, n = 58), and male (73.30%, n = 88). Nearly half of the participants were frail (45.85%, n = 55). Compared to non-frail, frail individuals had significantly higher scores in the total HIV-related stigma (M = 98.5 ± 24.7 vs. M = 85.3 ± 25.6, p = .020) and all subscales. The odds of multidimensional frailty were 1.021 times higher for people with higher HIV-related stigma scores (p = .007). This association remained significant after adjustment for income and comorbidities (p = .049). Conclusions: HIV-related stigma among older Latino PWH was significantly associated with their odds of being frail. Efforts to prevent multidimensional frailty should consider addressing HIV-related stigma through age-appropriate and culturally tailored resources for this group.
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Affiliation(s)
- Evelyn Iriarte
- College of Nursing, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
- School of Nursing, Pontificia Universidad Católica de Chile, Macul, Santiago, Chile
- Millennium Institute for Care Research, MICARE (ICS2019_024), Santiago, Chile
| | - Rosina Cianelli
- School of Nursing, Pontificia Universidad Católica de Chile, Macul, Santiago, Chile
- School of Nursing and Health Studies, University of Miami, Coral Gables, FL, USA
| | - Joseph P De Santis
- School of Nursing and Health Studies, University of Miami, Coral Gables, FL, USA
| | - Natalia Villegas
- School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Lisette Irarrazabal
- School of Nursing, Pontificia Universidad Católica de Chile, Macul, Santiago, Chile
| | - Catherine Jankowski
- College of Nursing, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
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Factors Related to Multidimensional Frailty Among Hispanic People Living With HIV Aged 50 Years and Above: A Cross-sectional Study. J Assoc Nurses AIDS Care 2023; 34:259-269. [PMID: 36917646 DOI: 10.1097/jnc.0000000000000398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/15/2023]
Abstract
ABSTRACT Among Hispanics, frailty has been extensively studied as a physical syndrome associated with an increased risk for adverse outcomes. Because of additional barriers to accessing care, the impact of frailty may be even more significant for people living with HIV (PLWH). Multidimensional frailty among Hispanic PLWH has not been studied. This study aimed to examine the factors related to multidimensional frailty among Hispanic PLWH aged 50 years and above. A cross-sectional design with 120 participants was used. Hypothesized factors related to multidimensional frailty were sociodemographic and psychosocial variables. Multidimensional frailty was measured with the Tilburg Frailty Indicator. We found that 45.83% of the participants were frail ( n = 55), and multidimensional frailty was significantly associated with higher depressive symptoms ( b = .26, p < .001) and a higher number of comorbidities ( b = .71, p < .001). This study identified factors that clinicians should be aware of when caring for Hispanic PLWH to prevent or manage frailty-related complications.
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St Clair-Sullivan N, Simmons K, Harding-Swale R, Levett T, Maddocks M, Roberts J, Trotman D, Yi D, Vera JH, Bristowe K. Frailty and frailty screening: A qualitative study to elicit perspectives of people living with HIV and their healthcare professionals. HIV Med 2022; 24:480-490. [PMID: 36229192 DOI: 10.1111/hiv.13419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 09/24/2022] [Indexed: 11/28/2022]
Abstract
OBJECTIVES People living with HIV are an ageing population with an increasing prevalence of frailty. Management of frailty requires assessment, communication and information sharing with patients. However, evidence regarding the meaning of frailty for this population, and the acceptability of frailty screening, is limited. This study aimed to explore the perceptions of older people living with HIV and HIV professionals towards frailty and routine screening for frailty. METHODS Data collection consisted of in-depth individual qualitative interviews with older people living with HIV and focus groups with HIV professionals purposively sampled from outpatient HIV clinics in London and Brighton, UK. Verbatim pseudonymised transcripts were analysed using reflexive thematic analysis supported by NVivo. RESULTS A total of 45 people living with HIV were interviewed, and 12 HIV professionals participated in two focus groups. Frailty was described as a series of losses around mobility, social inclusion, independence and mental acuity, which could happen at any age. Regarding language, for people living with HIV, explicitly using the word frail was acceptable during screening when approached sensitively and alongside provision of information and support to slow the progression of frailty. However, HIV professionals described concerns about using the word frail for fear of causing distress or offence. CONCLUSION Professionals described frailty in terms of functional deficits, whereas people living with HIV described a loss of personhood. Although there is a clear desire among people living with HIV to be informed of their frailty status, approaching conversations about frailty with understanding and compassion is vital. To gain the most from the screening, it is essential that frailty status is shared alongside a clear plan of actionable steps in their care.
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Affiliation(s)
- Natalie St Clair-Sullivan
- Brighton and Sussex Medical School, Brighton, UK.,King's College London, Cicely Saunders Institute of Palliative Care, Policy & Rehabilitation, London, UK
| | | | - Richard Harding-Swale
- King's College London, Cicely Saunders Institute of Palliative Care, Policy & Rehabilitation, London, UK
| | | | - Matthew Maddocks
- King's College London, Cicely Saunders Institute of Palliative Care, Policy & Rehabilitation, London, UK
| | | | - Daniel Trotman
- King's College Hospital NHS Foundation Trust, London, UK
| | - Deokhee Yi
- King's College London, Cicely Saunders Institute of Palliative Care, Policy & Rehabilitation, London, UK
| | - Jaime H Vera
- Brighton and Sussex Medical School, Brighton, UK
| | - Katherine Bristowe
- King's College London, Cicely Saunders Institute of Palliative Care, Policy & Rehabilitation, London, UK
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