Aging and Frailty; the case of HIV-positive and HIV-negative individuals in Ghana: A case-control study

Abstract

Background Physical frailty remains an important health challenge associated with aging. HIV infection may influence the development of physical frailty. This may lead to persons living with HIV experiencing adverse health outcomes that result from physical frailty at earlier ages as compared to persons who are HIV-negative. There is inadequate knowledge of frailty among Ghanaians especially in persons living with HIV. This study sought to investigate the prevalence and factors associated with frailty among elderly persons (older adults) with or without HIV infection in Ghana. Methodology: This case-control study was conducted from January 2020 to December 2020. A total of 181 elderly persons were recruited for this study. Sociodemographic and lifestyle data were obtained with a structured questionnaire. Blood samples were obtained to determine the HIV status of individuals whose HIV status was unknown for exclusion purposes. Frailty was assessed by the Frailty Phenotype Tool. Statistical values with p < 0.05 were considered statistically significant. Results Out of the 181 participants, 42.5% (n = 77) were known HIV-positive individuals on antiretroviral therapy whereas 57.5% of participants in this study were HIV-negative. While the overall prevalence of frailty was 15.5% (n = 28), the prevalence of frailty among HIV-negative adults was 12.5% (n = 13) and that recorded among HIV-positive elderly persons was 19.5% (n = 15). Occupation (p = 0.020), age (p = 0.049), smoking status (p = 0.029), and not having multiple sex partners (p = 0.031) were associated with frailty among HIV-negative older adults. Conclusion: Frailty is more common among elderly persons with HIV infection than those without HIV infection, with nearly 2 out of 10 elderly HIV-infected persons being frail. No significant association was observed between frailty status and sociodemographics and lifestyle characteristics among the HIV-positive participants. We conclude that frailty is common among Ghanaian older adults and it is a bigger problem in elderly persons living with HIV infection.