Bone and Muscle Frailty Twice as Prevalent in Men Living with HIV

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

Men living with HIV age very differently than HIV-negative men, but the team behind this study focused on assessing how the extent of differences in aging.

Investigators from the Multicenter AIDS Cohort Study studied 399 men, 200 being HIV-negative and 199 being HIV-positive. MACS is an ongoing thirty-year study of men living with HIV.  All of the men that were assessed for the project were between the ages of 50 and 69 years. The prevalence of frailty was twice as common in HIV-positive men, at 16 percent, than in HIV-negative men, at eight percent. All men who were HIV-positive were taking antiretroviral drugs and generally had their CD4 counts under control.

Risk factors associated with frailty included abdominal obesity, loss of skeletal muscle mass called sarcopenia and osteoporosis. Investigators assess body composition include the participants’ body mass index, waist circumference, bone density and other problems. 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.

Frailty — which is what researchers have called “The Silent Epidemic” — is a real concern for people living with HIV. Frailty 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, but the characteristics include weight loss. It also causes 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 tablets. The best thing you can do is simply to 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 effects of HIV is one of the ways HIV can cause frailty in middle-aged and older men living with HIV. Watching your waistline and keeping track of what foods you are eating can help prevent frailty problems further down the line.