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

Abstract

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. 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. 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. 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.