The Growing Pains That Come with Aging with HIV

New findings published in the June issue of the medical journal AIDS reveal that frailty is twice as prevalent in middle-aged and elderly men living with HIV as it is with HIV-negative men. Researchers also found that men living with HIV who had high waist measurements were more likely to suffer from frailty than men with smaller waists.

Frailty generally includes weakness, exhaustion, slowness, low physical activity, and or unintentional weight loss, according to Johns Hopkins University School of Medicine researcher Qian-Li Xue, who reported on the frailty syndrome for the journal Clinics in
Geriatric Medicine.

People living with HIV age somewhat differently than those without it overall, but the team behind this study focused on assessing the extent of differences in aging for men.

Investigators from the Multicenter AIDS Cohort Study (MACS) studied 399 men, 200 being HIV-negative and 199 being HIV-positive. MACS is an ongoing 30-year study of men living with the virus. All of the men who were assessed for the project were between the ages of 50 and 69. The prevalence of frailty was found to be twice as common in HIV-positive men — 16 percent compared to 8 percent. All HIV-positive men were taking antiretroviral drugs and most were virally suppressed.

Risk factors associated with frailty included abdominal obesity and loss of skeletal muscle mass, most commonly due to either sarcopenia or osteoporosis. Investigators assessed body composition, including the mens’ body mass index, waist circumference, and bone density. The risk factors, however, did not differ by HIV status.

“We found robust associations between frailty and central adiposity and sarcopenia. To the best of our knowledge, the association between frailty and VAT [visceral adipose tissue] area in adult men with HIV has not been previously reported,” the study’s authors said. The combination of these symptoms, researchers said, is probably due to underlying chronic inflammation and immune response.

Researchers have called frailty the “Silent Epidemic,” and it has been a real concern for people living with HIV. It is connected to low bone density and muscle mass, and can hamper the ability to carry out common daily tasks. Ironically, frailty can be caused by high waistlines, though the characteristics can also include weight loss. Additionally, it can cause exhaustion, slow walking speed, and low levels of strength. The connection between frailty and body composition in men living with HIV is not completely understood. Several other studies in recent years have attempted to decode how frailty is related to HIV.

There are a few things that men living with HIV can do to avoid being limited by frailty, including taking Vitamin D supplements. The best thing you can do is simply be aware of the real risks that are associated with HIV-related bone density loss and related problems.

The loss of skeletal muscle mass is something men living with HIV need to be aware of. “Higher abdominal obesity and sarcopenia were associated with frailty among men with and without HIV,” investigators concluded. “Assessment of these body composition parameters may help detect frailty in the clinical setting.”

The constant inflammatory effect of HIV is one of the ways the virus may cause frailty in middle-aged and older men living with the chronic condition. Watching your waistline and keeping track of what foods you are eating can help prevent frailty problems further down the line.