HIV and Aging: New Data on an Expanding Problem

By Michael Broder, PhD
Reviewed by Mark Wainberg, PhD, Director, McGill University AIDS Centre, Montreal, Quebec, Canada

Take Note

  • Estimates are that more than 50% of people living with HIV in the United States are now aged 50 or older
  • Older patients with HIV are affected by typical age-related chronic conditions but are also at increased risk for liver disease, cardiovascular disease, and kidney disease, among other conditions
  • These health burdens point to the need for specialists in HIV and aging to jointly develop clinical and social services specifically designed to meet the needs of this growing population

More than 50% of people living with HIV in the United States (US) are now aged 50 or older.1 People with HIV are living longer because of effective antiretroviral therapy (ART).1 Older patients with HIV are affected by chronic conditions that are common among older Americans generally, but are also at increased risk for certain comorbidities, including liver disease, cardiovascular disease, kidney disease, non-AIDS-related cancers, osteoporosis, and neurocognitive decline.2 While geriatricians typically expect to see frailty (a condition characterized by weight loss, weakness, and increased risk of disability and death) and functional impairment beginning at age 65, these conditions frequently appear earlier in patients with HIV.1,2

Older patients with HIV are at increased risk for multimorbidity (concurrent chronic disease affecting multiple organ systems),3 polypharmacy (commonly defined as being on 5 or more medications concurrently), psychiatric co-morbidities (such as depression and neurocognitive disorders), and social issues such as isolation and loneliness,1 all of which can contribute to poor clinical outcomes.1

These health burdens point to the need for clinical and social services specifically designed to meet the needs of older HIV patients. The impetus is growing for HIV specialists and geriatric specialists to meet the complex long-term needs of older HIV patients.1………….

Published: 07/21/2016

References:

  1. John M, Greene M, Hessol NA, et al. Geriatric assessments and association with VACS Index among HIV-infected older adults in San Francisco. J Acquir Immune Defic Syndr. 2016 Mar 29. [Epub ahead of print]
  2. Workgroup for HIV and Aging Consensus Project. Recommended treatment strategies for clinicians managing older patients with HIV. 2011
  3. Brooks JT, Buchacz K, Gebo KA, Mermin J. HIV infection and older Americans: the public health perspective. Am J Public Health. 2012;102:1516-1526
  4. Justice AC, McGinnis KA, Skanderson M, et al. Towards a combined prognostic index for survival in HIV infection: the role of
  5. Graf C. The Lawton instrumental activities of daily living scale. Am J Nurs. 2008 Apr;108(4):52-62; quiz 62-3. doi: 10.1097/01.NAJ.0000314810.46029.74

 

 

 

 

http://www.medpagetoday.com/resource-center/Contemporary-HIV-Management/Aging/a/59239

filed under: HIV