Frailty: a new vulnerability indicator in people aging with HIV

Purpose: To review the concept of frailty and its measurement, describe the existing data on frailty in people living with HIV, examine the limits of frailty as a marker of vulnerability in people living with HIV, and explore how frailty measurement could be incorporated into HIV care. Methods: Narrative literature review. Results: Frailty is an emerging marker of vulnerability that is increasingly being assessed among people aging with HIV. Which frailty measurement tool is best for people with HIV has not yet been established, and likely depends on clinical context. Evaluation of vulnerability should take into account social and structural factors. Frailty assessment can be incorporated into clinical care as a part of comprehensive geriatric assessment. Models of HIV–geriatric care are being established. Conclusions: As a group, people with HIV are aging and increasingly face multiple interacting age-related medical and social problems. It requires remarkable resilience to age successfully with HIV. The clinical care of people aging with HIV could benefit from a focus on frailty and related social vulnerability to better understand patients’ needs and develop appropriate goals and care plans.