Tobacco Smoking and Pack-Years Are Associated With Frailty Among People With HIV

Stephanie A. Ruderman; Michelle C. Odden; Allison R. Webel; Annette L. Fitzpatrick; Paul K. Crane; Robin M. Nance; Lydia N. Drumright; Bridget M. Whitney; Lyndsey Sarah Mixson; Jimmy Ma; Amanda L. Willig; Lara Haidar; Sherif Eltonsy; Kenneth H. Mayer; Conall O'Cleirigh; Karen L. Cropsey; Joseph J. Eron; Sonia Napravnik; Meredith Greene; Mary McCaul; Geetanjali Chander; Edward Cachay; William B. Lober; Stephen B. Kritchevsky; Steven Austad; Alan Landay; Chintan Pandya; Francisco Cartujano-Barrera; Michael S. Saag; Charles Kamen; Andrew W. Hahn; Mari M. Kitahata; Joseph A.C. Delaney; Heidi M. Crane

doi:10.1097/QAI.0000000000003242

Tobacco Smoking and Pack-Years Are Associated With Frailty Among People With HIV

Stephanie A. Ruderman, Michelle C. Odden, Allison R. Webel, Annette L. Fitzpatrick, Paul K. Crane, Robin M. Nance, Lydia N. Drumright, Bridget M. Whitney, Lyndsey Sarah Mixson, Jimmy Ma, Amanda L. Willig, Lara Haidar, Sherif Eltonsy, Kenneth H. Mayer, Conall O'Cleirigh, Karen L. Cropsey, Joseph J. Eron, Sonia Napravnik, Meredith Greene, Mary McCaulGeetanjali Chander, Edward Cachay, William B. Lober, Stephen B. Kritchevsky, Steven Austad, Alan Landay, Chintan Pandya, Francisco Cartujano-Barrera, Michael S. Saag, Charles Kamen, Andrew W. Hahn, Mari M. Kitahata, Joseph A.C. Delaney, Heidi M. Crane

Research output: Contribution to journal › Article › peer-review

Abstract

Background:Tobacco smoking increases frailty risk among the general population and is common among people with HIV (PWH) who experience higher rates of frailty at younger ages than the general population.Methods:We identified 8608 PWH across 6 Centers for AIDS Research Network of Integrated Clinical Systems sites who completed ≥2 patient-reported outcome assessments, including a frailty phenotype measuring unintentional weight loss, poor mobility, fatigue, and inactivity, and scored 0-4. Smoking was measured as baseline pack-years and time-updated never, former, or current use with cigarettes/day. We used Cox models to associate smoking with risk of incident frailty (score ≥3) and deterioration (frailty score increase by ≥2 points), adjusted for demographics, antiretroviral medication, and time-updated CD4 count.Results:The mean follow-up of PWH was 5.3 years (median: 5.0), the mean age at baseline was 45 years, 15% were female, and 52% were non-White. At baseline, 60% reported current or former smoking. Current (HR: 1.79; 95% confidence interval: 1.54 to 2.08) and former (HR: 1.31; 95% confidence interval: 1.12 to 1.53) smoking were associated with higher incident frailty risk, as were higher pack-years. Current smoking (among younger PWH) and pack-years, but not former smoking, were associated with higher risk of deterioration.Conclusions:Among PWH, smoking status and duration are associated with incident and worsening frailty.

Original language	English (US)
Pages (from-to)	135-142
Number of pages	8
Journal	Journal of Acquired Immune Deficiency Syndromes
Volume	94
Issue number	2
DOIs	https://doi.org/10.1097/QAI.0000000000003242
State	Published - Oct 1 2023
Externally published	Yes

Keywords

HIV and aging
frailty
people with HIV
tobacco smoking

ASJC Scopus subject areas

Infectious Diseases
Pharmacology (medical)

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10.1097/QAI.0000000000003242

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Ruderman, S. A., Odden, M. C., Webel, A. R., Fitzpatrick, A. L., Crane, P. K., Nance, R. M., Drumright, L. N., Whitney, B. M., Mixson, L. S., Ma, J., Willig, A. L., Haidar, L., Eltonsy, S., Mayer, K. H., O'Cleirigh, C., Cropsey, K. L., Eron, J. J., Napravnik, S., Greene, M., ... Crane, H. M. (2023). Tobacco Smoking and Pack-Years Are Associated With Frailty Among People With HIV. Journal of Acquired Immune Deficiency Syndromes, 94(2), 135-142. https://doi.org/10.1097/QAI.0000000000003242

Ruderman, SA, Odden, MC, Webel, AR, Fitzpatrick, AL, Crane, PK, Nance, RM, Drumright, LN, Whitney, BM, Mixson, LS, Ma, J, Willig, AL, Haidar, L, Eltonsy, S, Mayer, KH, O'Cleirigh, C, Cropsey, KL, Eron, JJ, Napravnik, S, Greene, M, McCaul, M, Chander, G, Cachay, E, Lober, WB, Kritchevsky, SB, Austad, S, Landay, A, Pandya, C, Cartujano-Barrera, F, Saag, MS, Kamen, C, Hahn, AW, Kitahata, MM, Delaney, JAC & Crane, HM 2023, 'Tobacco Smoking and Pack-Years Are Associated With Frailty Among People With HIV', Journal of Acquired Immune Deficiency Syndromes, vol. 94, no. 2, pp. 135-142. https://doi.org/10.1097/QAI.0000000000003242

@article{e250c330b5c34cd68ee550ce18856ead,

title = "Tobacco Smoking and Pack-Years Are Associated With Frailty Among People With HIV",

abstract = "Background:Tobacco smoking increases frailty risk among the general population and is common among people with HIV (PWH) who experience higher rates of frailty at younger ages than the general population.Methods:We identified 8608 PWH across 6 Centers for AIDS Research Network of Integrated Clinical Systems sites who completed ≥2 patient-reported outcome assessments, including a frailty phenotype measuring unintentional weight loss, poor mobility, fatigue, and inactivity, and scored 0-4. Smoking was measured as baseline pack-years and time-updated never, former, or current use with cigarettes/day. We used Cox models to associate smoking with risk of incident frailty (score ≥3) and deterioration (frailty score increase by ≥2 points), adjusted for demographics, antiretroviral medication, and time-updated CD4 count.Results:The mean follow-up of PWH was 5.3 years (median: 5.0), the mean age at baseline was 45 years, 15% were female, and 52% were non-White. At baseline, 60% reported current or former smoking. Current (HR: 1.79; 95% confidence interval: 1.54 to 2.08) and former (HR: 1.31; 95% confidence interval: 1.12 to 1.53) smoking were associated with higher incident frailty risk, as were higher pack-years. Current smoking (among younger PWH) and pack-years, but not former smoking, were associated with higher risk of deterioration.Conclusions:Among PWH, smoking status and duration are associated with incident and worsening frailty.",

keywords = "HIV and aging, frailty, people with HIV, tobacco smoking",

author = "Ruderman, {Stephanie A.} and Odden, {Michelle C.} and Webel, {Allison R.} and Fitzpatrick, {Annette L.} and Crane, {Paul K.} and Nance, {Robin M.} and Drumright, {Lydia N.} and Whitney, {Bridget M.} and Mixson, {Lyndsey Sarah} and Jimmy Ma and Willig, {Amanda L.} and Lara Haidar and Sherif Eltonsy and Mayer, {Kenneth H.} and Conall O'Cleirigh and Cropsey, {Karen L.} and Eron, {Joseph J.} and Sonia Napravnik and Meredith Greene and Mary McCaul and Geetanjali Chander and Edward Cachay and Lober, {William B.} and Kritchevsky, {Stephen B.} and Steven Austad and Alan Landay and Chintan Pandya and Francisco Cartujano-Barrera and Saag, {Michael S.} and Charles Kamen and Hahn, {Andrew W.} and Kitahata, {Mari M.} and Delaney, {Joseph A.C.} and Crane, {Heidi M.}",

year = "2023",

month = oct,

day = "1",

doi = "10.1097/QAI.0000000000003242",

language = "English (US)",

volume = "94",

pages = "135--142",

journal = "Journal of Acquired Immune Deficiency Syndromes",

issn = "1525-4135",

publisher = "Wolters Kluwer Health",

number = "2",

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TY - JOUR

T1 - Tobacco Smoking and Pack-Years Are Associated With Frailty Among People With HIV

AU - Ruderman, Stephanie A.

AU - Odden, Michelle C.

AU - Webel, Allison R.

AU - Fitzpatrick, Annette L.

AU - Crane, Paul K.

AU - Nance, Robin M.

AU - Drumright, Lydia N.

AU - Whitney, Bridget M.

AU - Mixson, Lyndsey Sarah

AU - Ma, Jimmy

AU - Willig, Amanda L.

AU - Haidar, Lara

AU - Eltonsy, Sherif

AU - Mayer, Kenneth H.

AU - O'Cleirigh, Conall

AU - Cropsey, Karen L.

AU - Eron, Joseph J.

AU - Napravnik, Sonia

AU - Greene, Meredith

AU - McCaul, Mary

AU - Chander, Geetanjali

AU - Cachay, Edward

AU - Lober, William B.

AU - Kritchevsky, Stephen B.

AU - Austad, Steven

AU - Landay, Alan

AU - Pandya, Chintan

AU - Cartujano-Barrera, Francisco

AU - Saag, Michael S.

AU - Kamen, Charles

AU - Hahn, Andrew W.

AU - Kitahata, Mari M.

AU - Delaney, Joseph A.C.

AU - Crane, Heidi M.

PY - 2023/10/1

Y1 - 2023/10/1

N2 - Background:Tobacco smoking increases frailty risk among the general population and is common among people with HIV (PWH) who experience higher rates of frailty at younger ages than the general population.Methods:We identified 8608 PWH across 6 Centers for AIDS Research Network of Integrated Clinical Systems sites who completed ≥2 patient-reported outcome assessments, including a frailty phenotype measuring unintentional weight loss, poor mobility, fatigue, and inactivity, and scored 0-4. Smoking was measured as baseline pack-years and time-updated never, former, or current use with cigarettes/day. We used Cox models to associate smoking with risk of incident frailty (score ≥3) and deterioration (frailty score increase by ≥2 points), adjusted for demographics, antiretroviral medication, and time-updated CD4 count.Results:The mean follow-up of PWH was 5.3 years (median: 5.0), the mean age at baseline was 45 years, 15% were female, and 52% were non-White. At baseline, 60% reported current or former smoking. Current (HR: 1.79; 95% confidence interval: 1.54 to 2.08) and former (HR: 1.31; 95% confidence interval: 1.12 to 1.53) smoking were associated with higher incident frailty risk, as were higher pack-years. Current smoking (among younger PWH) and pack-years, but not former smoking, were associated with higher risk of deterioration.Conclusions:Among PWH, smoking status and duration are associated with incident and worsening frailty.

AB - Background:Tobacco smoking increases frailty risk among the general population and is common among people with HIV (PWH) who experience higher rates of frailty at younger ages than the general population.Methods:We identified 8608 PWH across 6 Centers for AIDS Research Network of Integrated Clinical Systems sites who completed ≥2 patient-reported outcome assessments, including a frailty phenotype measuring unintentional weight loss, poor mobility, fatigue, and inactivity, and scored 0-4. Smoking was measured as baseline pack-years and time-updated never, former, or current use with cigarettes/day. We used Cox models to associate smoking with risk of incident frailty (score ≥3) and deterioration (frailty score increase by ≥2 points), adjusted for demographics, antiretroviral medication, and time-updated CD4 count.Results:The mean follow-up of PWH was 5.3 years (median: 5.0), the mean age at baseline was 45 years, 15% were female, and 52% were non-White. At baseline, 60% reported current or former smoking. Current (HR: 1.79; 95% confidence interval: 1.54 to 2.08) and former (HR: 1.31; 95% confidence interval: 1.12 to 1.53) smoking were associated with higher incident frailty risk, as were higher pack-years. Current smoking (among younger PWH) and pack-years, but not former smoking, were associated with higher risk of deterioration.Conclusions:Among PWH, smoking status and duration are associated with incident and worsening frailty.

KW - HIV and aging

KW - frailty

KW - people with HIV

KW - tobacco smoking

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DO - 10.1097/QAI.0000000000003242

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AN - SCOPUS:85171309865

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JO - Journal of Acquired Immune Deficiency Syndromes

JF - Journal of Acquired Immune Deficiency Syndromes

IS - 2

ER -

Tobacco Smoking and Pack-Years Are Associated With Frailty Among People With HIV

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