ingest
cdrApp
2018-08-23T17:24:58.091Z
d39a25df-af15-48e9-aec2-c9af81a997a2
modifyDatastreamByValue
RELS-EXT
fedoraAdmin
2018-08-23T17:25:48.112Z
Setting exclusive relation
addDatastream
MD_TECHNICAL
fedoraAdmin
2018-08-23T17:25:59.450Z
Adding technical metadata derived by FITS
addDatastream
MD_FULL_TEXT
fedoraAdmin
2018-08-23T17:26:21.824Z
Adding full text metadata extracted by Apache Tika
modifyDatastreamByValue
RELS-EXT
fedoraAdmin
2018-08-23T17:26:43.887Z
Setting exclusive relation
modifyDatastreamByValue
MD_DESCRIPTIVE
cdrApp
2018-09-27T17:42:24.961Z
modifyDatastreamByValue
MD_DESCRIPTIVE
cdrApp
2019-03-21T18:54:53.856Z
Terra
Fatukasi
Author
Department of Epidemiology
Gillings School of Global Public Health
FRAILTY PREVALENCE, ONE-YEAR RISK, AND THE EFFECT OF SMOKING AMONG WOMEN WITH AND WITHOUT HIV INFECTION
The gap in life expectancy between people with HIV and the general population is diminishing. However, evidence suggests that people with HIV may be experiencing aging-related conditions at earlier ages. The objective of this dissertation was to estimate the prevalence of frailty, a syndrome of physical vulnerability, estimate the one-year risk of frailty, and examine the effect of smoking on the one-year risk of frailty among women with and at risk for HIV. This project used data from the Women’s Interagency HIV Study between October 2015 and September 2017. The Fried Frailty Index was used to define frail status as exceeding the threshold for at least three of five frailty components: slowness, weakness, unintentional weight loss, exhaustion, and low physical activity. Among 1,404 women with a median age of 52 years (interquartile range: 47-57), we found that frailty prevalence was 11.5% (15.3% HIV-, 10.1% HIV+). The most common frailty components were low physical activity and exhaustion. The one-year risk of frailty was 6.6% (95% confidence interval: 4.1, 9.1) and similar for women with and without HIV. After adjustment for confounding, current smokers were 1.68 times as likely to become frail compared to non-smokers (95% CI: 0.69, 4.06). Women with high cumulative smoking exposure were 2.72 times as likely to become frail compared to women with low cumulative smoking exposure (95% CI: 0.96, 7.67), and this latter effect appeared to be more pronounced among women with HIV (adjusted RR = 4.10; 95% CI: 1.22, 13.78). In a low income, predominately black population of women in their mid-fifties with and without HIV infection, the prevalence and risk of frailty is comparable to women in the general population at least 65 years old. Reported smoking exposure is independently associated with increased frailty risk in this population, even over a one-year period of follow-up. These findings demonstrate that modifiable risk factors, such as smoking, could play a crucial role in preventing frailty, especially among people with HIV. Future studies are needed to investigate trends in frailty risk over time and to examine the long-term impacts of smoking on frailty among people with HIV.
Summer 2018
2018
Epidemiology
frailty, HIV, human immunodeficiency virus, incidence, prevalence, smoking, women
eng
Doctor of Philosophy
Dissertation
University of North Carolina at Chapel Hill Graduate School
Degree granting institution
Epidemiology
Adaora
Adimora
Thesis advisor
Stephen
Cole
Thesis advisor
Andrew
Edmonds
Thesis advisor
Jessie
Edwards
Thesis advisor
Deborah
Gustafson
Thesis advisor
text
Terra
Fatukasi
Creator
Department of Epidemiology
Gillings School of Global Public Health
FRAILTY PREVALENCE, ONE-YEAR RISK, AND THE EFFECT OF SMOKING AMONG WOMEN WITH AND WITHOUT HIV INFECTION
The gap in life expectancy between people with HIV and the general population is diminishing. However, evidence suggests that people with HIV may be experiencing aging-related conditions at earlier ages. The objective of this dissertation was to estimate the prevalence of frailty, a syndrome of physical vulnerability, estimate the one-year risk of frailty, and examine the effect of smoking on the one-year risk of frailty among women with and at risk for HIV. This project used data from the Women’s Interagency HIV Study between October 2015 and September 2017. The Fried Frailty Index was used to define frail status as exceeding the threshold for at least three of five frailty components: slowness, weakness, unintentional weight loss, exhaustion, and low physical activity. Among 1,404 women with a median age of 52 years (interquartile range: 47-57), we found that frailty prevalence was 11.5% (15.3% HIV-, 10.1% HIV+). The most common frailty components were low physical activity and exhaustion. The one-year risk of frailty was 6.6% (95% confidence interval: 4.1, 9.1) and similar for women with and without HIV. After adjustment for confounding, current smokers were 1.68 times as likely to become frail compared to non-smokers (95% CI: 0.69, 4.06). Women with high cumulative smoking exposure were 2.72 times as likely to become frail compared to women with low cumulative smoking exposure (95% CI: 0.96, 7.67), and this latter effect appeared to be more pronounced among women with HIV (adjusted RR = 4.10; 95% CI: 1.22, 13.78). In a low income, predominately black population of women in their mid-fifties with and without HIV infection, the prevalence and risk of frailty is comparable to women in the general population at least 65 years old. Reported smoking exposure is independently associated with increased frailty risk in this population, even over a one-year period of follow-up. These findings demonstrate that modifiable risk factors, such as smoking, could play a crucial role in preventing frailty, especially among people with HIV. Future studies are needed to investigate trends in frailty risk over time and to examine the long-term impacts of smoking on frailty among people with HIV.
Epidemiology
frailty; HIV; human immunodeficiency virus; incidence; prevalence; smoking; women
Doctor of Philosophy
Dissertation
University of North Carolina at Chapel Hill Graduate School
Degree granting institution
Epidemiology
Adaora
Adimora
Thesis advisor
Stephen
Cole
Thesis advisor
Andrew
Edmonds
Thesis advisor
Jessie
Edwards
Thesis advisor
Deborah
Gustafson
Thesis advisor
2018
2018-08
eng
text
Terra
Fatukasi
Creator
Department of Epidemiology
Gillings School of Global Public Health
FRAILTY PREVALENCE, ONE-YEAR RISK, AND THE EFFECT OF SMOKING AMONG WOMEN WITH AND WITHOUT HIV INFECTION
The gap in life expectancy between people with HIV and the general population is diminishing. However, evidence suggests that people with HIV may be experiencing aging-related conditions at earlier ages. The objective of this dissertation was to estimate the prevalence of frailty, a syndrome of physical vulnerability, estimate the one-year risk of frailty, and examine the effect of smoking on the one-year risk of frailty among women with and at risk for HIV. This project used data from the Women’s Interagency HIV Study between October 2015 and September 2017. The Fried Frailty Index was used to define frail status as exceeding the threshold for at least three of five frailty components: slowness, weakness, unintentional weight loss, exhaustion, and low physical activity. Among 1,404 women with a median age of 52 years (interquartile range: 47-57), we found that frailty prevalence was 11.5% (15.3% HIV-, 10.1% HIV+). The most common frailty components were low physical activity and exhaustion. The one-year risk of frailty was 6.6% (95% confidence interval: 4.1, 9.1) and similar for women with and without HIV. After adjustment for confounding, current smokers were 1.68 times as likely to become frail compared to non-smokers (95% CI: 0.69, 4.06). Women with high cumulative smoking exposure were 2.72 times as likely to become frail compared to women with low cumulative smoking exposure (95% CI: 0.96, 7.67), and this latter effect appeared to be more pronounced among women with HIV (adjusted RR = 4.10; 95% CI: 1.22, 13.78). In a low income, predominately black population of women in their mid-fifties with and without HIV infection, the prevalence and risk of frailty is comparable to women in the general population at least 65 years old. Reported smoking exposure is independently associated with increased frailty risk in this population, even over a one-year period of follow-up. These findings demonstrate that modifiable risk factors, such as smoking, could play a crucial role in preventing frailty, especially among people with HIV. Future studies are needed to investigate trends in frailty risk over time and to examine the long-term impacts of smoking on frailty among people with HIV.
Epidemiology
frailty; HIV; human immunodeficiency virus; incidence; prevalence; smoking; women
Doctor of Philosophy
Dissertation
University of North Carolina at Chapel Hill Graduate School
Degree granting institution
Adaora
Adimora
Thesis advisor
Stephen
Cole
Thesis advisor
Andrew
Edmonds
Thesis advisor
Jessie
Edwards
Thesis advisor
Deborah
Gustafson
Thesis advisor
2018
2018-08
eng
text
Fatukasi_unc_0153D_17900.pdf
uuid:ad83f1f0-d188-4217-867f-32b2a6678332
2020-08-23T00:00:00
2018-07-17T15:11:08Z
proquest
application/pdf
1063171