ArticleJournal of the American Geriatrics Society2023
Assessing the contributions of modifiable risk factors to serious falls and fragility fractures among older persons living with HIV.
Article in Journal of the American Geriatrics Society, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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Who cites it
15 citing papers in PubMed.
- Elevated Plasma GDF-15 Levels Are Associated with Aging, Multimorbidity, and Tobacco Exposure in People with HIV.Infectious diseases and therapy · 2026Article
- Polypharmacy in HIV: Rethinking what counts and why it matters.HIV medicine · 2026Review
- Modeled Health and Economic Burden of Frailty and Falls Among Adults With HIV.JAMA network open · 2026Article
- Incidence of frailty-related fracture among Medicaid beneficiaries living with HIV and cancer: A cohort study.PloS one · 2026Article
- Incidence of frailty-related fracture among Medicaid beneficiaries living with HIV and cancer: A cohort study.medRxiv : the preprint server for health sciences · 2025Article
- Updates on bone health in people living with HIV: global impact, prediction tools, and treatment.Current opinion in HIV and AIDS · 2025Review
- Narrative Review on the Management of Neck of Femur Fractures in People Living with HIV: Challenges, Complications, and Long-Term Outcomes.Microorganisms · 2025Review
- Risk factors for cognitive decline in persons with HIV.Current opinion in infectious diseases · 2025Review
- An explainable web application based on machine learning for predicting fragility fracture in people living with HIV: data from Beijing Ditan Hospital, China.Frontiers in cellular and infection microbiology · 2025Article
- Alcohol Use and Its Associations With Frailty, Fractures, and Falls Among Older Adults With HIV.Alcohol research : current reviews · 2025Review
- Challenges of HIV Management in an Aging Population.Current HIV/AIDS reports · 2024Review
- Bone Tissue Changes in Individuals Living with HIV/AIDS: The Importance of a Hierarchical Approach in Investigating Bone Fragility.Journal of personalized medicine · 2024Review
- An update on drug-drug interactions in older adults living with human immunodeficiency virus (HIV).Expert review of clinical pharmacology · 2024Review
- Polypharmacy Is Associated With Slow Gait Speed and Recurrent Falls in Older People With HIV.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2024Article
- BoneScore: A natural language processing algorithm to extract bone mineral density data from DXA scans.Health informatics journalArticle
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Authors and funding
12 authors.
Funding
Abstract
backgroundAlthough 50 years represents middle age among uninfected individuals, studies have shown that persons living with HIV (PWH) begin to demonstrate elevated risk for serious falls and fragility fractures in the sixth decade; the proportions of these outcomes attributable to modifiable factors are unknown.
methodsWe analyzed 21,041 older PWH on antiretroviral therapy (ART) from the Veterans Aging Cohort Study from 01/01/2010 through 09/30/2015. Serious falls were identified by Ecodes and a machine-learning algorithm applied to radiology reports. Fragility fractures (hip, vertebral, and upper arm) were identified using ICD9 codes. Predictors for both models included a serious fall within the past 12 months, body mass index, physiologic frailty (VACS Index 2.0), illicit substance and alcohol use disorders, and measures of multimorbidity and polypharmacy. We separately fit multivariable logistic models to each outcome using generalized estimating equations. From these models, the longitudinal extensions of average attributable fraction (LE-AAF) for modifiable risk factors were estimated.
resultsKey risk factors for both outcomes included physiologic frailty (VACS Index 2.0) (serious falls [15%; 95% CI 14%-15%]; fractures [13%; 95% CI 12%-14%]), a serious fall in the past year (serious falls [7%; 95% CI 7%-7%]; fractures [5%; 95% CI 4%-5%]), polypharmacy (serious falls [5%; 95% CI 4%-5%]; fractures [5%; 95% CI 4%-5%]), an opioid prescription in the past month (serious falls [7%; 95% CI 6%-7%]; fractures [9%; 95% CI 8%-9%]), and diagnosis of alcohol use disorder (serious falls [4%; 95% CI 4%-5%]; fractures [8%; 95% CI 7%-8%]).
conclusionsThis study confirms the contributions of risk factors important in the general population to both serious falls and fragility fractures among older PWH. Successful prevention programs for these outcomes should build on existing prevention efforts while including risk factors specific to PWH.
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