Functional Decline and QoL in People Aging With HIV in Asia

Study Overview
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Brief Summary
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This is a multi-center prospective cross-sectional study to determine the burden of decline in intrinsic capacity and functional ability, and the prevalence of geriatric syndromes, such as frailty, and disability in adult people living with HIV (PLWH) in Asia.

Detailed Description
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This research project is expected to have the following clinical impact To understand the impact of impaired functional status in PLWH in Asia would be important to determine the long-term health burden needs in this aging population in this part of the world. The identification of risk factors associated with impaired functional status would be important to guide clinical decisions in patient management, such as the choice of anti-retroviral regimen, and screening of and early intervention for modifiable risk factors. These are of paramount importance in the promotion of healthy aging in this population. This proposed cross-sectional study lays the foundation for the establishment of a longitudinal cohort for long-term follow up of people aging with HIV in Asia, with the objectives of evaluating the long-term impact of aging on clinical outcomes and functional status in PLWH in this region.

Official Title
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Functional Decline and Quality of Life in People Aging With HIV in Asia

Conditions
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Frailty, Disability Physical, HIV/AIDS

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: HIV antibody positive Age 35 years or above Asian ethnicity, including but not limited to Chinese, Malay and Indian Exclusion Criteria: Inability or refusal to consent Active infections requiring in-hospital treatment

Ages Eligible for Study
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Minimum Age: 35 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| PLWH<br>PLWH followed up at the five participating HIV centers | |
| HIV-uninfected individuals<br>Age and sex-matched HIV-uninfected individuals | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Functional disability | Functional disability is defined as any difficulty in any of the six areas of functioning in daily life as assessed by WHO DAS II questionnaire | 24 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Composite score for intrinsic capacity | The score is based on (i) self-reported questions assessing the subjects' eight health domains, including mobility, self-care, cognition, interpersonal activities, vision, pain and discomfort, sleep and energy, and affect, and (ii) measures of grip strength, short physical performance battery and cognitive function | 24 months | 
| Physical performance | Physical performance is measured by six-metre usual gait speed. Low physical performance is defined as usual gait speed ≤0.8 m/s | 24 months | 
| Cognitive decline | Cognitive decline is defined as presence of HIV-associated neurocognitive disorder (HAND) according to Frascati Criteria. Asymptomatic neurocognitive impairment (ANI) involves impairment of cognitive functioning in at least two ability domains, in the absence of interference in everyday functioning. Mild neurocognitive disorder (MND) also involves impairment in at least two ability domains, with at least mild interference in daily functioning. HIV-associated dementia (HAD) requires marked impairment in cognitive functioning in at least two ability domains, in the presence of marked impairment in day-to-day functioning | 24 months | 
| Frailty | Frailty is measured using the frailty index | 24 months | 
| Sarcopenia | Sarcopenia is defined as height-adjusted skeletal muscle mass <7.0 kg/m2 in men and 5.7 kg/m2 in women using BIA | 24 months | 
| Health-related quality of life | Health-related quality of life will be assessed as measured by WHO HIV BREF QOL. | 24 months |