Aging-Related Concerns of People Living with HIV Referred for Geriatric Consultation

Eugenia L Siegler,1 Jerad H Moxley,1 Marshall J Glesby2 1Division of Geriatrics and Palliative Care, Weill Cornell Medicine, New York, NY, 10065, USA; 2Division of Infectious Diseases, Weill Cornell Medicine, New York, NY, 10065, USACorrespondence: Eugenia L SieglerDivision of Geriatrics and Palliat...

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Autores principales:	Siegler EL, Moxley JH, Glesby MJ
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2021
Materias:	comprehensive geriatric assessment comorbidity frailty iadl Immunologic diseases. Allergy RC581-607
Acceso en línea:	https://doaj.org/article/9c24420fdd994dfab2d3e07646a72ff3
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spelling	oai:doaj.org-article:9c24420fdd994dfab2d3e07646a72ff32021-12-02T14:53:56ZAging-Related Concerns of People Living with HIV Referred for Geriatric Consultation1179-1373https://doaj.org/article/9c24420fdd994dfab2d3e07646a72ff32021-04-01T00:00:00Zhttps://www.dovepress.com/aging-related-concerns-of-people-living-with-hiv-referred-for-geriatri-peer-reviewed-fulltext-article-HIVhttps://doaj.org/toc/1179-1373Eugenia L Siegler,1 Jerad H Moxley,1 Marshall J Glesby2 1Division of Geriatrics and Palliative Care, Weill Cornell Medicine, New York, NY, 10065, USA; 2Division of Infectious Diseases, Weill Cornell Medicine, New York, NY, 10065, USACorrespondence: Eugenia L SieglerDivision of Geriatrics and Palliative Medicine, Weill Cornell Medicine, 525 E. 68th Street, Box 39, New York, NY, 10065, USATel +1 212 746 1729Fax +1 212 746 4888Email els2006@med.cornell.eduPurpose: People with HIV (PWH) are living longer lives and likely experiencing accentuated aging. Comprehensive geriatric assessment (CGA) has been proposed as a way to identify and help meet each individual patient’s needs.Patients and Methods: We performed a retrospective review of the results of CGA in an HIV clinic in New York City. CGA included assessment of basic and instrumental activities of daily living, screens for depression, anxiety, frailty, cognition, and quality of life, along with general discussion of concerns and goals. We compared the group of PWH referred for CGA to those of comparable age who were not referred to determine the factors that were associated with referral. We carried out a descriptive analysis of those undergoing CGA, along with regression to determine factors associated with poorer PHQ-2 depression scores and higher VACS score.Results: A total of 105 patients underwent full CGA during the study period. Mean age of referred patients was 66.5 years, ranging from 50 to 84 years (SD 7.99). More than 92% were virally suppressed. Compared with their non-referred counterparts over 50, referred patients were older and had more functional comorbidities like cerebrovascular disease, neuropathy, and urinary incontinence. More than half complained of fatigue, and 2/3 noted poor memory. Almost 60% were frail or prefrail. Ninety patients were asked about their goals, and the most commonly cited were related to health or finances; fifteen patients were unable to articulate any goals. Having fewer goals and noting weight loss or fatigue were predictive of higher scores on the PHQ-2 depression screen.Conclusion: Although most older PWH undergoing CGA can manage their ADL, many have concerns and deficits beyond their comorbidities. CGA offers an important window into the psychosocial concerns and needs of older PWH.Keywords: comprehensive geriatric assessment, comorbidity, frailty, IADLSiegler ELMoxley JHGlesby MJDove Medical Pressarticlecomprehensive geriatric assessmentcomorbidityfrailtyiadlImmunologic diseases. AllergyRC581-607ENHIV/AIDS: Research and Palliative Care, Vol Volume 13, Pp 467-474 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	comprehensive geriatric assessment comorbidity frailty iadl Immunologic diseases. Allergy RC581-607
spellingShingle	comprehensive geriatric assessment comorbidity frailty iadl Immunologic diseases. Allergy RC581-607 Siegler EL Moxley JH Glesby MJ Aging-Related Concerns of People Living with HIV Referred for Geriatric Consultation
description	Eugenia L Siegler,1 Jerad H Moxley,1 Marshall J Glesby2 1Division of Geriatrics and Palliative Care, Weill Cornell Medicine, New York, NY, 10065, USA; 2Division of Infectious Diseases, Weill Cornell Medicine, New York, NY, 10065, USACorrespondence: Eugenia L SieglerDivision of Geriatrics and Palliative Medicine, Weill Cornell Medicine, 525 E. 68th Street, Box 39, New York, NY, 10065, USATel +1 212 746 1729Fax +1 212 746 4888Email els2006@med.cornell.eduPurpose: People with HIV (PWH) are living longer lives and likely experiencing accentuated aging. Comprehensive geriatric assessment (CGA) has been proposed as a way to identify and help meet each individual patient’s needs.Patients and Methods: We performed a retrospective review of the results of CGA in an HIV clinic in New York City. CGA included assessment of basic and instrumental activities of daily living, screens for depression, anxiety, frailty, cognition, and quality of life, along with general discussion of concerns and goals. We compared the group of PWH referred for CGA to those of comparable age who were not referred to determine the factors that were associated with referral. We carried out a descriptive analysis of those undergoing CGA, along with regression to determine factors associated with poorer PHQ-2 depression scores and higher VACS score.Results: A total of 105 patients underwent full CGA during the study period. Mean age of referred patients was 66.5 years, ranging from 50 to 84 years (SD 7.99). More than 92% were virally suppressed. Compared with their non-referred counterparts over 50, referred patients were older and had more functional comorbidities like cerebrovascular disease, neuropathy, and urinary incontinence. More than half complained of fatigue, and 2/3 noted poor memory. Almost 60% were frail or prefrail. Ninety patients were asked about their goals, and the most commonly cited were related to health or finances; fifteen patients were unable to articulate any goals. Having fewer goals and noting weight loss or fatigue were predictive of higher scores on the PHQ-2 depression screen.Conclusion: Although most older PWH undergoing CGA can manage their ADL, many have concerns and deficits beyond their comorbidities. CGA offers an important window into the psychosocial concerns and needs of older PWH.Keywords: comprehensive geriatric assessment, comorbidity, frailty, IADL
format	article
author	Siegler EL Moxley JH Glesby MJ
author_facet	Siegler EL Moxley JH Glesby MJ
author_sort	Siegler EL
title	Aging-Related Concerns of People Living with HIV Referred for Geriatric Consultation
title_short	Aging-Related Concerns of People Living with HIV Referred for Geriatric Consultation
title_full	Aging-Related Concerns of People Living with HIV Referred for Geriatric Consultation
title_fullStr	Aging-Related Concerns of People Living with HIV Referred for Geriatric Consultation
title_full_unstemmed	Aging-Related Concerns of People Living with HIV Referred for Geriatric Consultation
title_sort	aging-related concerns of people living with hiv referred for geriatric consultation
publisher	Dove Medical Press
publishDate	2021
url	https://doaj.org/article/9c24420fdd994dfab2d3e07646a72ff3
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Aging-Related Concerns of People Living with HIV Referred for Geriatric Consultation

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