Prevalence and Factors Associated With Frailty Among Older Adults Living With HIV Compared to Their Uninfected Peers From the Kenyan Coast

Patrick N Mwangala; Carophine Nasambu; Ryan G Wagner; Charles R Newton; Amina Abubakar

doi:10.3389/ijph.2024.1606284

Prevalence and Factors Associated With Frailty Among Older Adults Living With HIV Compared to Their Uninfected Peers From the Kenyan Coast

Int J Public Health. 2024 Feb 15:69:1606284. doi: 10.3389/ijph.2024.1606284. eCollection 2024.

Authors

Patrick N Mwangala^{1

2

3}, Carophine Nasambu², Ryan G Wagner⁴, Charles R Newton^{1

2

5

6}, Amina Abubakar^{1

2

5

6}

Affiliations

¹ Institute for Human Development, Aga Khan University, Nairobi, Kenya.
² Centre for Geographic Medicine Research Coast, Kenya Medical Research Institute (KEMRI), Kilifi, Kenya.
³ School of Public Health, University of the Witwatersrand, Johannesburg, South Africa.
⁴ MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
⁵ Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, United Kingdom.
⁶ Department of Public Health, Pwani University, Kilifi, Kenya.

Abstract

Objectives: a) To document the prevalence and correlates of frailty among older adults living with HIV (OALWH) and their uninfected peers, and b) Investigate HIV status as an independent predictor of frailty. Methods: This cross-sectional study was conducted between 2020 and 2021 at the Kenyan coast among 440 older adults aged ≥50 years (257 OALWH). Frailty was assessed using the Reported Edmonton Frail Scale. Logistic regression was used to examine the correlates of frailty. Results: The prevalence of frailty was significantly higher among OALWH (24%) than their uninfected peers (13%). HIV seropositivity was not independently associated with frailty. Sleeping difficulties, ageism, higher waist/hip ratio, visiting traditional healers, HIV treatment change/interruption, prolonged illness following HIV diagnosis, and self-reported diabetes were significantly associated with higher odds of frailty. Residing in larger households, having higher income, having friends, being male and light physical activities were significantly associated with reduced odds of frailty. Conclusion: The prevalence of frailty is elevated among OALWH; however, factors other than HIV are predominant, particularly psychosocial factors. Multicomponent interventions are needed to prevent/delay and manage frailty in this setting.

Keywords: HIV; aging; correlates; frailty; sub-Saharan Africa.

MeSH terms

Aged
Cross-Sectional Studies
Female
Frail Elderly
Frailty* / epidemiology
HIV Infections* / epidemiology
Humans
Kenya / epidemiology
Male
Prevalence

Grants and funding

This work was funded by the Wellcome Trust International Master’s Fellowship to PM (Grant number 208283/Z/17/Z). Further funding supporting this work was from 1) the Medical Research Council (Grant number MR/M025454/1) to AA. This award is jointly funded by the UK Medical Research Council (MRC) and the UK Department for International Development (DFID) under MRC/DFID concordant agreement and is also part of the EDCTP2 program supported by the European Union; 2) DELTAS Africa Initiative [DEL-15-003]. The DELTAS Africa Initiative is an independent funding scheme of the African Academy of Sciences (AAS)’s Alliance for Accelerating Excellence in Science in Africa (AESA) and supported by the New Partnership for Africa’s Development Planning and Coordinating Agency (NEPAD Agency) with funding from the Wellcome Trust [107769/Z/10/Z] and the UK government. The funders did not have a role in the design and conduct of the study or interpretation of study findings. RW is supported by the South African National Research Foundation (119234).