Sex Differences in the Prevalence of Geriatric Syndromes Among Older People Living with HIV Attending an Urban Outpatient Clinic in Kampala, Uganda

Phoebe Mbabazi; Grace Banturaki; Suzan Naikoba; Esther M Nasuuna; Yukari C Manabe; Meredith Greene; Barbara Castelnuovo

doi:10.2147/HIV.S489598

Sex Differences in the Prevalence of Geriatric Syndromes Among Older People Living with HIV Attending an Urban Outpatient Clinic in Kampala, Uganda

HIV AIDS (Auckl). 2024 Nov 26:16:455-465. doi: 10.2147/HIV.S489598. eCollection 2024.

Authors

Phoebe Mbabazi¹, Grace Banturaki¹, Suzan Naikoba¹, Esther M Nasuuna¹, Yukari C Manabe^{1

2}, Meredith Greene³, Barbara Castelnuovo¹

Affiliations

¹ Research Department, Infectious Disease Institute, College of Health Sciences, Makerere University, Kampala, Uganda.
² Division of Infectious Diseases, Department of Medicine, John Hopkins University, Baltimore, MD, USA.
³ Division of General Internal Medicine & Geriatrics, Indiana University School of Medicine, Indianapolis, Indiana, USA.

Abstract

Background: Older people living with HIV (PLHIV) are at high risk of developing geriatric syndromes. Data on geriatric syndromes among older PLHIV in sub-Saharan Africa are scarce. We examined sex differences in the prevalence and correlates of geriatric syndromes among PLHIV aged ≥60 years on antiretroviral therapy in Kampala, Uganda.

Methods: This cross-sectional study analyzed data obtained during the enrollment of older PLHIV into a prospective observational cohort in Kampala. We used the Poisson regression model to explore the association between the number of geriatric syndromes and non-communicable diseases (NCDs), sociodemographic factors, and HIV-related factors.

Results: We included 500 participants (48.8% women) with a median age of 64 years (interquartile range, IQR: 62.68). Almost all (94.4%) participants had at least one geriatric syndrome. More women were frail (13.1% vs 5.1%, P-value = 0.01) and had lower physical performance measured using the Short Physical Performance Battery (43.3% vs 26.6%, P-value < 0.01). Similarly, more women had cognitive impairment (83.2% vs 62.9%, P-value < 0.01) and reported falling (48.8% vs 34.0%, P-value < 0.01). Women (adjusted mean ratio, AMR 1.17, 95% CI 1.05-1.30, P-value < 0.01), older age (AMR 1.11, 95% CI 1.07-1.16, P-value < 0.01), no formal education (AMR 1.39, 95% CI 1.06-1.82, P-value = 0.01), underweight (AMR 1.49, 95% CI 1.26-1.76, P-value < 0.01), World Health Organization (WHO) stage 3 or 4 (AMR 1.11, 95% CI 0.01-1.22, P-value = 0.04) and having two or more NCDs (AMR 1.11, 95% CI 1.00-1.23, P-value = 0.04) were associated with a higher number of geriatric syndromes.

Conclusion: The prevalence of geriatric syndromes was high among older PLHIV and was more common in women. There is a need to incorporate the screening and management of geriatric syndromes into the care of older PLHIV in sub-Saharan Africa, with a particular focus on women.

Keywords: HIV; geriatric syndromes; older adults; sub-Saharan Africa.

Grants and funding

The “Diagnosis and treatment of non-communicable diseases and geriatric syndromes in the HIV aging population in sub-Saharan Africa” study is part of the European & Developing Countries Clinical Trials Partnership (EDCTP2) program supported by the European Union, grant agreement number TMA2017GSF-1936. The funding body did not influence the study design, collection, analysis, and interpretation of the data or writing of the manuscript. This report was also supported by the Fogarty International Center of the National Institutes of Health under Award Number D43TW009771. The content is solely the authors’ responsibility and does not necessarily represent the official views of the National Institutes of Health.