Background Neurocognitive impairment (NCI) is strongly associated with frailty in people living with human immunodeficiency virus (PLWH); the overlap of frailty and NCI and the impact on health outcomes in PLWH are unknown. Methods PLWH in a longitudinal, observational study of aging completed entry evaluations for frailty and NCI. Outcomes of falls (recurrent) increased limitations in independent activities of daily living (IADL), or mortality were combined. Poisson regression models estimated prevalence ratios (PR) for ≥1 outcome over 2 years. Results Among 987 participants, the median age at entry was 51 years; 19% were female; the median CD4 count was 616 cells/µL; and HIV-1 RNA was <200 copies/mL in 94%. Most (79%) participants had neither frailty nor NCI; 2% had both; 4% frailty only; and 15% NCI only. Over 2 years of observation, 100 (10%) participants experienced recurrent falls; 175 (18%) had worsening IADL limitations; 17 (2%) died; and 254 (26%) experienced ≥1 poor health outcome. In adjusted models, frailty with NCI was associated with more than double the risk of a poor health outcome (PR 2.65; 95% CI 1.98, 3.54); a significant association was also seen with frailty alone (PR 2.26; 95%CI 1.71, 2.99) and NCI alone (PR 1.73; 95% CI 1.36, 2.20). Conclusions The presence of frailty with NCI was associated with a greater risk of falls, disability, or death in PLWH than NCI alone. Interventions that target prevention or reversal of both frailty and NCI (such as increased physical activity) may significantly limit poor health outcomes among PLWH.

中文翻译：

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在预测患有人类免疫缺陷病毒的成年人健康状况不佳时，身体虚弱，神经认知障碍或两者兼而有之。

背景技术神经认知障碍（NCI）与人类免疫缺陷病毒（PLWH）患者的虚弱密切相关。体弱和NCI的重叠以及对PLWH对健康结局的影响尚不清楚。方法：PLWH在纵向观察性衰老研究中完成了对脆弱和NCI的进入评估。跌倒的结果（反复发生）增加了独立活动（IADL）的局限性或死亡率。Poisson回归模型估计2年内≥1个结局的患病率（PR）。结果987名参与者中，入组年龄中位数为51岁；而入组年龄中位数为51岁。19％是女性；CD4中位数为616细胞/ µL；HIV-1 RNA的<200拷贝/ mL占94％。大多数（79％）的参与者既没有虚弱也没有NCI。2％的人同时拥有；仅4％虚弱；和15％的NCI。经过2年的观察，100（10％）位参与者经历了反复跌倒；175名（18％）的IADL限制在恶化；17人（2％）死亡；254名（26％）的健康结果≥1。在调整后的模型中，NCI虚弱与健康状况差的风险增加了一倍以上（PR 2.65； 95％CI 1.98，3.54）；单独的虚弱（PR 2.26； 95％CI 1.71，2.99）和单独的NCI（PR 1.73； 95％CI 1.36，2.20）也存在显着相关性。结论NCI脆弱的存在与PLWH中跌倒，残疾或死亡的风险相比，单独存在NCI的风险更大。旨在预防或逆转脆弱和NCI的干预措施（例如增加体育锻炼）可能会大大限制PLWH的不良健康结果。254名（26％）的健康结果≥1。在调整后的模型中，NCI虚弱与健康状况差的风险增加了一倍以上（PR 2.65； 95％CI 1.98，3.54）；单独的虚弱（PR 2.26； 95％CI 1.71，2.99）和单独的NCI（PR 1.73； 95％CI 1.36，2.20）也存在显着相关性。结论NCI脆弱的存在与PLWH中跌倒，残疾或死亡的风险相比，单独存在NCI的风险更大。旨在预防或逆转脆弱和NCI的干预措施（例如增加体育锻炼）可能会大大限制PLWH的不良健康结果。254名（26％）的健康结果≥1。在调整后的模型中，NCI虚弱与健康状况差的风险增加了一倍以上（PR 2.65； 95％CI 1.98，3.54）；单独的虚弱（PR 2.26； 95％CI 1.71，2.99）和单独的NCI（PR 1.73； 95％CI 1.36，2.20）也存在显着相关性。结论NCI脆弱的存在与PLWH中跌倒，残疾或死亡的风险相比，单独存在NCI的风险更大。旨在预防或逆转脆弱和NCI的干预措施（例如增加体育锻炼）可能会大大限制PLWH的不良健康结果。95％CI 1.71，2.99）和单独的NCI（PR 1.73; 95％CI 1.36，2.20）。结论NCI脆弱的存在与PLWH中跌倒，残疾或死亡的风险相比，单独存在NCI的风险更大。旨在预防或逆转脆弱和NCI的干预措施（例如增加体育锻炼）可能会大大限制PLWH的不良健康结果。95％CI 1.71，2.99）和单独的NCI（PR 1.73; 95％CI 1.36，2.20）。结论NCI脆弱的存在与PLWH中跌倒，残疾或死亡的风险相比，单独存在NCI的风险更大。旨在预防或逆转脆弱和NCI的干预措施（例如增加体育锻炼）可能会大大限制PLWH的不良健康结果。