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Assessment of Geriatric Syndromes and Physical Function in People Living with HIV.

Assessment of Geriatric Syndromes and Physical Function in People Living with HIV.
Author Information (click to view)

Greene M, Justice AC, Covinsky KE,


Greene M, Justice AC, Covinsky KE, (click to view)

Greene M, Justice AC, Covinsky KE,

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Virulence 2016 Oct 7() 0

Abstract

As the number of older adults living with HIV continues to increase, understanding how to incorporate geriatric assessments within HIV care will be critical. Assessment of geriatric syndromes and physical function can be useful tools for HIV clinicians and researchers to help identify the most vulnerable older adults and to better understand the aging process in PLWH. This review focuses on the assessment of falls, frailty and physical function, first in the general population of older adults and includes a specific focus on use of these assessments in older adults living with HIV. With advances in antiretroviral therapy, HIV has transformed into a chronic illness. (1) As a result, people living with HIV (PLWH) are living substantially longer. As the population of PLWH ages, many are facing increased medical complexity including multiple chronic conditions or multimorbidity, polypharmacy, and significant psychosocial challenges including mental health conditions and isolation. (2) With this increasing complexity, clinicians and researchers need tools to help identify the most vulnerable older adults who may need the most resources as they age. Drawing on assessments used in geriatrics and gerontology, assessment of physical function and geriatric syndromes could help to better define aging trajectories in older adults living with HIV. Understanding how to assess for these conditions is critical given the increasing numbers of older adults living with HIV in the US and worldwide. The focus of this review is on the assessment of geriatric syndromes and physical function and how these assessments may be applied to HIV settings. Although a brief overview of geriatric syndromes is included, this review will focus on the specific geriatric syndromes of falls, frailty and assessment of physical function as these have been most studied in HIV.

METHODS
PubMed was searched for articles using terms "geriatric syndrome", "frailty", "falls", "physical function", "functional status" with limits of aged, middle aged, aged 80 and older with and without addition of "HIV" search terms. Searches were also conducted pertaining to specific assessments such as VACS index. Additionally, key articles and references pertaining to geriatric syndromes in the general population and key articles pertaining to HIV and geriatric syndromes known to the authors were also included.

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