Association between a lower T-CD4+ /CD8+ lymphocyte ratio and cognitive impairment in older persons with HIV.

Purpose: To ascertain the association between the LT-CD4 + /CD8 + ratio and cognitive impairment in older people living with HIV.

Methods: A cross-sectional study was conducted, including 207 adults aged > 50 years with HIV, receiving care at a tertiary-care hospital in Mexico City. Participants underwent a standardized geriatric and neuropsychological assessment to establish the presence of HIV-associated neurocognitive disorder according to the validated Antinori criteria.

Impact of a geriatric intervention based on the Comprehensive Geriatrics Assessment on avoidable admissions in older patients at risk evaluated in the Emergency Department.

Objective: To know the impact of a geriatric intervention based on the Comprehensive Geriatric Assessment (CGA) on avoidable admissions in older patients at risk evaluated in the Emergency Department.

Method: Prospective observational unicenter study. We included patients, from October 1, 2018 to January 31, 2020, over 75 years who were attended at the Emergency Department with a Triage Risk Screening Tool (TRST) score≥2.

A 12-week multicomponent exercise program enhances frailty by increasing robustness, improves physical performance, and preserves muscle mass in older adults with HIV: MOVIhNG study.

Background: Our aim was to analyze the effects of a multicomponent exercise program (MEP) on frailty and physical performance in older adults with HIV (OAWH) since exercise can reverse frailty in the older population overall, but there is no data for OAWH.

Methods: A prospective longitudinal study with intervention and control group was designed. Sedentary adults 50 or over with and without HIV were included.

Muscle mass loss measured with portable ultrasound in hospitalized older adults: The ECOSARC study.

Objectives: The main objective was to analyze the evolution of muscle of the Quadriceps Rectus Femoris (QRF) between admission and discharge, in older adults hospitalized with an acute medical disease in Acute Geriatric Units (AGUs).

Design: Prospective multicentric observational cohort study.

Setting: Seven AGUs from University Hospitals in Spain.

Predictive model for a second hip fracture occurrence using natural language processing and machine learning on electronic health records.

Hip fractures (HFx) are associated with a higher morbidity and mortality rates, leading to a significant reduction in life quality and in limitation of patient´s mobility. The present study aimed to obtain real-world evidence on the clinical characteristics of patients with an initial and a second hip fracture (HFx) and develop a predictive model for second HFx using artificial intelligence. Electronic health records from one hospital centre in Spain from January 2011 to December 2019 were analysed using EHRead® technology, based on natural language processing and machine learning.

Comparison of the Fecal Bacteriome of HIV-Positive and HIV-Negative Older Adults.

HIV infection is considered a scenario of accelerated aging. Previous studies have suggested a link between aging, frailty, and gut dysbiosis, but there is a knowledge gap regarding the HIV population. Our objective was to compare the fecal bacteriome of older people with HIV (PWH) and non-HIV controls, and to assess potential links between gut dysbiosis and frailty.

Characterization of data-driven geriatric syndrome clusters in older people with HIV: a Mexican multicenter cross-sectional study.

Background: As living with HIV has been proposed as a condition that may accelerate aging, the main objective of this work was to estimate the prevalence of geriatric syndromes (GS) among older Mexicans with HIV dwelling in the community. Secondly, to evaluate whether the accumulation of GS could be associated with an adverse HIV-related clinical profile, independent of chronological age.

Methods: Multicenter, cross-sectional study including 501 community-dwelling people aged ≥50 years with HIV.

"SARCOPENIA MEASURED BY ULTRASOUND IN HOSPITALIZED OLDER ADULTS" (ECOSARC): multi-centre, prospective observational study protocol.

Background: Measurement of muscle mass and function, and thereafter, screening and diagnosis of sarcopenia, is a challenge and a need in hospitalized older adults. However, it is difficult in complex real-world old patients, because usually they are unable to collaborate with clinical, functional, and imaging testing. Ultrasound measurement of quadriceps rectus femoris (QRF) provides a non-invasive, real-time assessment of muscle quantity and quality, and is highly acceptable to participants with excellent inter-rater and intra-rater variability.

An exploratory prospective study of the factors associated with adverse health outcomes in older adults living with HIV.

Objective: This study examines the clinical and sociodemographic factors associated with adverse health outcomes (falls, emergency room visits, hospital admissions and death) in a cohort of patients older than 55 years with HIV infection.

Methods: It is an exploratory prospective study with four years follow-up. People with HIV infection followed in the infectious diseases consultation unit of two hospitals in Madrid were included.

CD4/CD8 Ratio During Human Immunodeficiency Virus Treatment: Time for Routine Monitoring?

In the last decade, studies in persons with HIV (PWH) on antiretroviral therapy (ART) have shed light on the significance of persistently high CD8 counts and low CD4/CD8 ratios. A low CD4/CD8 ratio reflects increased immune activation and is associated with an increased risk of severe non-AIDS events. As a result, many clinicians now believe that the CD4/CD8 ratio can help in HIV monitoring, and many researchers now report it as an efficacy marker in interventional studies.

Effects of frailty, geriatric syndromes, and comorbidity on mortality and quality of life in older adults with HIV.

Background: To understand the effects of frailty, geriatric syndromes, and comorbidity on quality of life and mortality in older adults with HIV (OAWH).

Methods: Cross-sectional study of the FUNCFRAIL multicenter cohort. The setting was outpatient HIV-Clinic.

Different profiles among older adults with HIV according to their chronological age and the year of HIV diagnosis: The FUNCFRAIL cohort study (GeSIDA 9817).

Background: People in their fifties with HIV are considered older adults, but they appear not to be a homogeneous group.

Objective: To evaluate the differences among older adults with HIV according to their chronological age and the year of HIV diagnosis.

Methods: Cross-sectional study of the FUNCFRAIL cohort.

[Senior-friendly hospital: The hospital of the 21st century].

The current health system must be revolutionized to meet the specific and real requirements of the largest population attended, older adults, and tailor the hospital to their needs, not the other way round. This is the goal of Hospital Universitario Infanta Leonor: senior-friendly hospital. The project was established as a business process management system integrated into the management's hospital map.

Frailty: the current challenge for aging people with HIV.

Purpose Of Review: Older adults account for the majority of people with HIV (PWH) in high-income countries and have increasingly complex clinical profiles related to premature aging. Frailty is an important geriatric syndrome affecting a minority of PHW. Frailty negatively affects PHW's clinical status and quality of life.

Frailty, markers of immune activation and oxidative stress in HIV infected elderly.

People living with HIV-1 experience an accelerated aging due to the persistent and chronic activation of the immune system. This phenomenon conduces to immune exhaustion and precipitate immunosenescence. In general, frailty is defined as a syndrome of physiological degeneration in the elderly.

Sex Differences in People Aging With HIV.

Background: To evaluate differences between older women and men with HIV regarding HIV variables, comorbidity, physical function, and quality of life (QOL).

Setting: The Modena HIV clinic.

Methods: Prospective cohort study.

Deprescribing of non-antiretroviral therapy in HIV-infected patients.

Purpose: In recent decades, the life expectancy of HIV-infected patients has increased considerably, to the extent that the disease can now be considered chronic. In this context of progressive aging, HIV-infected persons have a greater prevalence of comorbid conditions. Consequently, they usually take more non-antiretroviral drugs, and their drug therapy are more complex.

The impact of hip fracture on health-related quality of life and activities of daily living: the SPARE-HIP prospective cohort study.

Purpose: The medical morbidity and mortality associated with neck of femur fractures is well-documented, whereas there is limited data for patient-reported outcomes. The aim of this study was to characterize the impact of neck of femur fractures on activities of daily living and patient-reported health-related quality of life.

Methods: Design and participants: Multicentric prospective cohort study.

European cohorts of older HIV adults: POPPY, AGEIV, GEPPO, COBRA and FUNCFRAIL.

Aim: The recent and rapid demographic changes affecting people living with HIV (PLWH) produced a subset of older adults demanding a prompt response both in clinical practice and research setting. The scientific community had to properly design studies that include older adults living with HIV (OALWH), aged > 50 years, or geriatric PLWH, aged > 65 years to explore the interaction between aging and HIV itself, antiretroviral therapy (ART) and non-infectious co-morbidities (NICM). Choosing between these two types of cohorts may represent a trap, but also a possibility to measure different outcomes and obtain different evidence.

Why are people with HIV considered "older adults" in their fifties?

One in six new HIV diagnoses in Europe occur among people over 50 years of age. As in the general population, the aging process is not homogeneous among older adults with HIV, and some of them exhibit impaired physical function, higher frailty and more frequent geriatric syndromes. These illness reflect a higher biological age independently of their chronological age.

Geriatric-HIV Medicine: the geriatrician's role.

The scenario of people living with HIV has dramatically changed, and nowadays older adults with HIV constitute almost half of the HIV population-and the percentage is growing. Frailty and geriatric syndromes have been highly demonstrated among older adults with HIV; therefore, the application of geriatric medicine principles to their approach has become essential. Geriatric-HIV Medicine, specific, collaborative work between HIV specialists and geriatricians, is a young discipline that has the goal of ensuring a global and specific approach to older patients that is focused on function and the continuum of care.

Frailty phenotype: a clinical marker of age acceleration in the older HIV-infected population.

Aim: To evaluate the association between DNA methylation and frailty in the HIV-infected population and to investigate the usefulness of assessing frailty as a clinical marker to identify age acceleration.

Methods: Frailty was assessed according to Fried's frailty phenotype. DNA methylation was analyzed in 10 frail patients, and compared with 10 robust control patients, all with HIV.

[HIV in Spain 2017: policies for a new management of chronicity beyond virological control].

The analysis of the available databases related to HIV/AIDS confirms a paradigm shift in the patient's life expectancy: now HIV has become a chronic disease, so patients are aging. However, this advance is accompanied by a negative counterpart: due to the increase in the number of years of life gained, there is a prevalence of comorbidities greater than the general population and at an earlier age. Reducing the risk associated with all the comorbidities that the ageing patient with HIV/AIDS may develop, must now be a health objective; it must be added to the traditional objectives that until now were part of the strategy to reduce the impact of the HIV infection.