AIDS (London, England) · 2025
Cross-sectional analysis of factors associated with low intrinsic capacity among Malaysians ageing with HIV in ambulatory care.
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Yap Siew Hwei, Hisham Syaza, Ho Wen Ying, Hor William Boon Wei, Tan Xin Woen, Zulhaimi Nurul Syuhada, Loh Jessica Seh Min, Neelamegam Malinee, Hasmukharay Kejal, Ong Han Cheng, Robbins Reuben, Wong Pui Li, Rajasuriar Reena
Аннотация
OBJECTIVE: Intrinsic capacity is a component of WHO's model for Health Ageing and a key determinant of an individual's functional ability as they age. However, little is known about what factors negatively influence intrinsic capacity among people with HIV (PWH).
DESIGN: Cross-sectional study.
METHOD: Participants included PWH [≥35 years and on antiretroviral therapy (ART) for a minimum of 12 months] attending HIV care in University Malaya Medical Centre. Intrinsic capacity scores were computed based on five key domains (sensory, mobility, cognition, vitality, and mood). Pareto analyses were performed to determine the domains impaired in the majority of participants, and multivariable linear regression to explore factors associated with low intrinsic capacity.
RESULTS: The median age in the 202 PWH were 50 years [interquartile range (IQR): 44-57 years] and median intrinsic capacity score was 5.60 (IQR: 4.80-5.80, max 6). Deficits in vitality were observed in 52.8% of participants, followed by cognition (18.8%) and mood (18.1%). Factors associated with low intrinsic capacity scores after adjusting for demographic and socioeconomic factors included multimorbidity [-0.130, 95% confidence interval (CI): -0.181, -0.079, P = 0.000] and polypharmacy (-0.077, 95% CI: -0.119, -0.036, P = 0.000), metabolic syndrome (-0.360, 95% CI: -0.568, -0.153, P = 0.001), renal disease (-0.450, 95% CI: -0.871, -0.029, P = 0.036) and diabetes (-0.337, 95% CI: -0.590, -0.085, P = 0.009), social isolation (0.021, 95% CI: 0.003, 0.039, P = 0.025), loneliness (-0.063, 95% CI: -0.114, -0.013, P = 0.014) and high high-sensitive C-reactive protein (hsCRP) (-0.028, 95% CI: -0.054, -0.002, P = 0.034).
CONCLUSION: Poor social connectedness and multimorbidity, particularly metabolic syndrome and renal disease, are significant risk factors for low intrinsic capacity scores among PWH in our setting. This study provides critical insights into potential strategies to improve trajectories of healthy ageing in PWH.
DESIGN: Cross-sectional study.
METHOD: Participants included PWH [≥35 years and on antiretroviral therapy (ART) for a minimum of 12 months] attending HIV care in University Malaya Medical Centre. Intrinsic capacity scores were computed based on five key domains (sensory, mobility, cognition, vitality, and mood). Pareto analyses were performed to determine the domains impaired in the majority of participants, and multivariable linear regression to explore factors associated with low intrinsic capacity.
RESULTS: The median age in the 202 PWH were 50 years [interquartile range (IQR): 44-57 years] and median intrinsic capacity score was 5.60 (IQR: 4.80-5.80, max 6). Deficits in vitality were observed in 52.8% of participants, followed by cognition (18.8%) and mood (18.1%). Factors associated with low intrinsic capacity scores after adjusting for demographic and socioeconomic factors included multimorbidity [-0.130, 95% confidence interval (CI): -0.181, -0.079, P = 0.000] and polypharmacy (-0.077, 95% CI: -0.119, -0.036, P = 0.000), metabolic syndrome (-0.360, 95% CI: -0.568, -0.153, P = 0.001), renal disease (-0.450, 95% CI: -0.871, -0.029, P = 0.036) and diabetes (-0.337, 95% CI: -0.590, -0.085, P = 0.009), social isolation (0.021, 95% CI: 0.003, 0.039, P = 0.025), loneliness (-0.063, 95% CI: -0.114, -0.013, P = 0.014) and high high-sensitive C-reactive protein (hsCRP) (-0.028, 95% CI: -0.054, -0.002, P = 0.034).
CONCLUSION: Poor social connectedness and multimorbidity, particularly metabolic syndrome and renal disease, are significant risk factors for low intrinsic capacity scores among PWH in our setting. This study provides critical insights into potential strategies to improve trajectories of healthy ageing in PWH.