TY - JOUR
T1 - Tobacco Smoking and Pack-Years Are Associated With Frailty Among People With HIV
AU - Ruderman, Stephanie A.
AU - Odden, Michelle C.
AU - Webel, Allison R.
AU - Fitzpatrick, Annette L.
AU - Crane, Paul K.
AU - Nance, Robin M.
AU - Drumright, Lydia N.
AU - Whitney, Bridget M.
AU - Mixson, Lyndsey Sarah
AU - Ma, Jimmy
AU - Willig, Amanda L.
AU - Haidar, Lara
AU - Eltonsy, Sherif
AU - Mayer, Kenneth H.
AU - O'Cleirigh, Conall
AU - Cropsey, Karen L.
AU - Eron, Joseph J.
AU - Napravnik, Sonia
AU - Greene, Meredith
AU - McCaul, Mary
AU - Chander, Geetanjali
AU - Cachay, Edward
AU - Lober, William B.
AU - Kritchevsky, Stephen B.
AU - Austad, Steven
AU - Landay, Alan
AU - Pandya, Chintan
AU - Cartujano-Barrera, Francisco
AU - Saag, Michael S.
AU - Kamen, Charles
AU - Hahn, Andrew W.
AU - Kitahata, Mari M.
AU - Delaney, Joseph A.C.
AU - Crane, Heidi M.
N1 - Publisher Copyright:
© 2021 Wolters Kluwer Health, Inc. All rights reserved.
PY - 2023/10/1
Y1 - 2023/10/1
N2 - Background:Tobacco smoking increases frailty risk among the general population and is common among people with HIV (PWH) who experience higher rates of frailty at younger ages than the general population.Methods:We identified 8608 PWH across 6 Centers for AIDS Research Network of Integrated Clinical Systems sites who completed ≥2 patient-reported outcome assessments, including a frailty phenotype measuring unintentional weight loss, poor mobility, fatigue, and inactivity, and scored 0-4. Smoking was measured as baseline pack-years and time-updated never, former, or current use with cigarettes/day. We used Cox models to associate smoking with risk of incident frailty (score ≥3) and deterioration (frailty score increase by ≥2 points), adjusted for demographics, antiretroviral medication, and time-updated CD4 count.Results:The mean follow-up of PWH was 5.3 years (median: 5.0), the mean age at baseline was 45 years, 15% were female, and 52% were non-White. At baseline, 60% reported current or former smoking. Current (HR: 1.79; 95% confidence interval: 1.54 to 2.08) and former (HR: 1.31; 95% confidence interval: 1.12 to 1.53) smoking were associated with higher incident frailty risk, as were higher pack-years. Current smoking (among younger PWH) and pack-years, but not former smoking, were associated with higher risk of deterioration.Conclusions:Among PWH, smoking status and duration are associated with incident and worsening frailty.
AB - Background:Tobacco smoking increases frailty risk among the general population and is common among people with HIV (PWH) who experience higher rates of frailty at younger ages than the general population.Methods:We identified 8608 PWH across 6 Centers for AIDS Research Network of Integrated Clinical Systems sites who completed ≥2 patient-reported outcome assessments, including a frailty phenotype measuring unintentional weight loss, poor mobility, fatigue, and inactivity, and scored 0-4. Smoking was measured as baseline pack-years and time-updated never, former, or current use with cigarettes/day. We used Cox models to associate smoking with risk of incident frailty (score ≥3) and deterioration (frailty score increase by ≥2 points), adjusted for demographics, antiretroviral medication, and time-updated CD4 count.Results:The mean follow-up of PWH was 5.3 years (median: 5.0), the mean age at baseline was 45 years, 15% were female, and 52% were non-White. At baseline, 60% reported current or former smoking. Current (HR: 1.79; 95% confidence interval: 1.54 to 2.08) and former (HR: 1.31; 95% confidence interval: 1.12 to 1.53) smoking were associated with higher incident frailty risk, as were higher pack-years. Current smoking (among younger PWH) and pack-years, but not former smoking, were associated with higher risk of deterioration.Conclusions:Among PWH, smoking status and duration are associated with incident and worsening frailty.
KW - frailty
KW - HIV and aging
KW - people with HIV
KW - tobacco smoking
UR - https://www.scopus.com/pages/publications/85171309865
UR - https://www.scopus.com/pages/publications/85171309865#tab=citedBy
U2 - 10.1097/QAI.0000000000003242
DO - 10.1097/QAI.0000000000003242
M3 - Article
C2 - 37368939
AN - SCOPUS:85171309865
SN - 1525-4135
VL - 94
SP - 135
EP - 142
JO - Journal of Acquired Immune Deficiency Syndromes
JF - Journal of Acquired Immune Deficiency Syndromes
IS - 2
ER -