ABSTRACT
BACKGROUND: The phenotype of frailty proposed by Fried et al has shown to predict several adverse health-related outcomes in elderly populations worldwide; however, the description of such associations in Latin America is still scarce. OBJECTIVE: To describe the association between frailty and recent hospitalization, disability for basic (ADL) and instrumental activities of daily living (IADL). DESIGN, SETTING AND PARTICIPANTS: Cross-sectional study of 1,124 community-dwelling adults aged 70 and older participating in the Coyoacán cohort. MEASUREMENTS: Frailty was defined by the presence of at least three of the following criteria: weight loss, exhaustion, low physical activity, slowness, and weakness. Multiple regression analyses were used to test the association between frailty and the outcomes of interest, adjusting for potential confounders. RESULTS: Mean age was 78.2 (SD ±6.1) years. Prevalence of frailty was 14.1%. Adjusted multivariate models showed that frail status was associated with ADL disability (OR 3.06, 95%CI 1.52-6.17), IADL disability (OR 17.02, 95%CI 6.16-47.01), and recent hospitalization (OR 3.21, 95%CI 1.31-7.8). CONCLUSION: Among Mexican community-dwelling elderly, frailty is associated with ADL and IADL disability as well as with recent hospitalizations. Moreover, frailty's prevalence in this population appears to be greater compared to what has been reported elsewhere. Social and cultural traits should be further studied as correlates of frailty in diverse populations.
ABSTRACT
An epidemiological transition is occurring regarding Human Immunodeficiency Virus (HIV) infection. This phenomenon, explained by several mechanisms (e.g.: physiologic changes, pharmacologic advances, sexual behaviors), is demonstrated by a significant increase in the number of patients aged 50 years and older diagnosed with this infection. The immunological changes observed in HIV-infected patients may prompt the appearance of an accelerated aging process as well as that of comorbidities and other pathological entities commonly diagnosed in older adults. Frailty is a biologic syndrome characterized by a multi-systemic decrease of the individual's physiologic and homeostatic reserves, leading to diminished resistance against stressors and increased vulnerability. The purpose of this review is to describe the common molecular changes seen in both frailty and HIV-1 infection, offering an in-depth analysis of their pathophysiology and specifying common processes where their pathways meet.
