Association of the Veterans Aging Cohort Study Index with Exercise Capacity in HIV-Infected Adults
Year: 2013
Type: article
Study design: Observational Study
Abstract: Physical disability is a major priority in aging, affecting morbidity, mortality, and quality of life. Despite the large number of adults aging with HIV, our understanding of the physiologic and clinical risk factors for disability is limited. Our goal is to determine whether the Veterans Aging Cohort Study (VACS) Index, based on routine clinical blood tests, could serve as a point of care screening tool to identify HIV-infected adults at high risk for physical disability. HIV-infected adults enrolled in the VACS participated in a cross-sectional exercise study with established measures of strength and endurance. The VACS Index was calculated using recent clinical laboratory values and age; a higher score reflects greater mortality risk. Statistical analyses included correlation and linear regression models adjusted for muscle mass. Fifty-five HIV-infected adults, predominantly African-American men, were included with age mean±SD of 52±7 years. Median (IQR) CD4 cell count was 356 cells/mm(3) (212-527). The VACS Index was inversely correlated with quadriceps strength (r=-0.45, p<0.01), grip strength (r=-0.28, p=0.04), and 6-min walk distance (r=-0.27, p=0.05). A 20-point increase in VACS Index score was associated with a 10% lower leg strength (p<0.01), which remained significant after adjustment for muscle cross-sectional area (p=0.02). The VACS Index explained 31% of the variance in specific leg strength. In this group of middle-aged adults with well-controlled HIV infection the VACS Index was significantly associated with upper and lower extremity strength. The VACS Index may be valuable for identification of patients at high risk for disability due to muscle weakness.
Institutions: University of Maryland, Baltimore, Baltimore VA Medical Center, Yale University, VA Connecticut Healthcare System, University of Washington, Johns Hopkins University, Rutgers, The State University of New Jersey, University of California, Los Angeles, VA Greater Los Angeles Healthcare System
Language: English
Subfield: Emergency Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: green
Funders: U.S. Department of Veterans Affairs, Georgia Clinical and Translational Science Alliance, National Institutes of Health, National Institute on Alcohol Abuse and Alcoholism, National Institute on Aging, National Heart, Lung, and Blood Institute, National Institute of Mental Health, National Institute of Nursing Research, National Center for Research Resources
Awards: G1019605141, G1041632141, G1158786059, G2358688911, G2410226815, 2/6 COMpAAAS U01: Observation Study, G3570311933, G3631044079, G380288914, 5/6 COMpAAAS U24: Resource in Informatics and Biostatistics (RIB), G4245087604, Alcohol Associated Outcomes Among HIV+/- Aging Veterans, Claude D. Pepper Older Americans Independence Center (O*, 1/6 COMpAAAS U24: Coordinating Center, Aging and Physical Functioning in HIV, G666483505, G6855373311, G7420383591, G7804600378, Longitudinal Studies of HIV-Associated Lung Infections and Complications, Yale University Clinical and Translational Science Award Program, G830759834, G86173648, G8733640360, University of Maryland Claude D. Pepper Older Americans Independence Center (OAIC), Center for Interdisciplinary Research on AIDS
OpenAlex ID: W1972201290