KNUST Aging and HIV Outcomes

KNUST 老龄化和艾滋病毒结果

基本信息

批准号：
10751613
负责人：
Nana Kwame Ayisi-Boateng
金额：
$ 14.28万
依托单位：
KWAME NKRUMAH UNIVERSITY/SCIENCE/TECH
依托单位国家：
美国
项目类别：
财政年份：
2023
资助国家：
美国
起止时间：
2023-07-10 至 2025-06-30
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10751613
关键词：
Acquired Immunodeficiency Syndrome Address Africa South of the Sahara African Aging Boston Cardiometabolic Disease Caring Categories Cessation of life Chronic Disease Clinical Communicable Diseases Complex Comprehensive Health Care Country Data Dependence Diagnosis Disease Disease Management Dyslipidemias Elderly Enrollment Epidemic Epidemiology Exposure to Family Practice Female Foundations Frequencies Future Geriatric Assessment Geriatrics Ghana Goals Guidelines HIV HIV therapy Health Personnel Health Services Healthcare Hypertension Impaired cognition Incidence Informed Consent Intervention Studies Interview Life Life Expectancy Longitudinal, observational study Measures Medical Records Mental Depression Mental Health Modeling Morbidity - disease rate Organ Outcome Outcome Study Participant Patient Self-Report Patients Perception Persons Phenotype Physical assessment Physiological Policies Polypharmacy Prevalence Principal Investigator Psychosocial Assessment and Care Quality of life Research Research Assistant Research Training Science Screening Result Structure Surveys Syndrome Technology Testing Universities University Hospitals Update Work aged aging and technology antiretroviral therapy care systems clinical practice community organizations diabetes management effective therapy effectiveness testing experience follow-up frailty healthy aging high risk human old age (65+)improved indexing kidney dysfunction mortality mortality risk multiple chronic conditions patient oriented peer physical conditioning policy implication pragmatic trial preservation programs satisfaction screening sex social vulnerability

Acquired Immunodeficiency Syndrome Address Africa South of the Sahara African Aging Boston Cardiometabolic Disease Caring Categories Cessation of life Chronic Disease Clinical Communicable Diseases Complex Comprehensive Health Care Country Data Dependence Diagnosis Disease Disease Management Dyslipidemias Elderly Enrollment Epidemic Epidemiology Exposure to Family Practice Female Foundations Frequencies Future Geriatric Assessment Geriatrics Ghana Goals Guidelines HIV HIV therapy Health Personnel Health Services Healthcare Hypertension Impaired cognition Incidence Informed Consent Intervention Studies Interview Life Life Expectancy Longitudinal, observational study Measures Medical Records Mental Depression Mental Health Modeling Morbidity - disease rate Organ Outcome Outcome Study Participant Patient Self-Report Patients Perception Persons Phenotype Physical assessment Physiological Policies Polypharmacy Prevalence Principal Investigator Psychosocial Assessment and Care Quality of life Research Research Assistant Research Training Science Screening Result Structure Surveys Syndrome Technology Testing Universities University Hospitals Update Work aged aging and technology antiretroviral therapy care systems clinical practice community organizations diabetes management effective therapy effectiveness testing experience follow-up frailty healthy aging high risk human old age (65+)improved indexing kidney dysfunction mortality mortality risk multiple chronic conditions patient oriented peer physical conditioning policy implication pragmatic trial preservation programs satisfaction screening sex social vulnerability

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项目摘要

Abstract Thanks to life-extending HIV therapy, there are an estimated 7 million people with HIV (PWH) aged over 50 years worldwide; 5 million of them live in sub-Saharan Africa, the epicenter of the HIV epidemic. Of the ~312,000 PWH in Ghana in 2019, almost 1 in 6 is aged over 50 years. Geriatric syndromes (e.g., frailty, multimorbidity) and discrete diseases of aging (e.g., hypertension) threaten these gains in healthier life expectancy for aging PWH. These threats are particularly troubling in Ghana and sub-Saharan African countries where access to geriatric care and chronic disease management is limited. Efforts underway in the region leverage HIV care systems to diagnose and manage chronic diseases of aging. A gap in these efforts is a focus on geriatric syndromes – multi-factorial clinical conditions, common in older PWH, that do not fit discrete disease categories. Filling this gap, particularly in the sub-Saharan Africa region, is the next barrier to extending quantity of life and preserving quality of life for aging PWH. To help fill this gap, our long-term goal is to provide comprehensive care for geriatric syndromes and diseases of aging without over-diagnosing or over- treating older PWH. The objectives of the current proposal are to 1) characterize frailty, multimorbidity, and discrete diseases of aging in older PWH; and 2) identify barriers and facilitators to providing effective patient- centered healthcare for older PWH. Frailty is associated with HIV, dependency and mortality. It is characterized by diminished strength, endurance, and functioning. Multimorbidity – multiple, interacting physical and mental health conditions – is associated with HIV, polypharmacy, morbidity and mortality. We hypothesize that 1) frailty and multimorbidity are under-recognized and discrete cardiometabolic diseases are under-diagnosed in older PWH in Ghana; and 2) Infectious Disease Unit referrals for discrete cardiometabolic diseases are not effective for their management in Ghana. To test these hypotheses, we propose a longitudinal observational study at the University Hospital Infectious Disease Unit, Kwame Nkrumah University of Science and Technology (KNUST) in Kumasi, Ghana. The study will enroll 151 PWH who are 50 years and older to address three specific aims: 1) Characterize frailty and multimorbidity in older PWH in care at the University Hospital, KNUST; 2) Assess under-diagnosis and management of discrete cardiometabolic diseases in older PWH; and 3) Identify barriers and facilitators to providing effective, patient centered healthcare to aging PWH. KNUST Aging & HIV Outcomes (KAHO) study will help identify priorities and opportunities for building an effective integrated model of HIV and geriatric healthcare in Ghana. This integrated model will extend the gains in quality life expectancy for Ghanaians and other Africans in similar settings who are aging with HIV.

抽象的感谢延长生命的艾滋病毒疗法，估计有700万人艾滋病毒（PWH）年龄在50岁以上全球多年；其中有500万生活在艾滋病毒流行的中心撒哈拉以南非洲。的 2019年在加纳的〜312,000 PWH，六分之六分之有50岁。老年综合征（例如脆弱，多种疾病）和衰老的离散疾病（例如，高血压）威胁到健康的生活衰老PWH的期望。这些威胁在加纳和撒哈拉以南非洲人尤其令人不安获得老年护理和慢性病管理的国家是有限的。在地区利用艾滋病毒护理系统来诊断和管理衰老的慢性疾病。这些努力的差距是对老年综合征的重点 - 多因素临床状况，在较旧的PWH中常见，不合适离散疾病类别。填补这一空白，特别是在撒哈拉以南非洲地区，是下一个障碍扩大衰老PWH的寿命和保留生活质量。为了帮助填补这一空白，我们的长期目标是为老年综合症和衰老疾病提供综合护理，而不会过度诊断或过度诊断治疗较老的PWH。当前提案的对象是1）表征脆弱，多发病和老年PWH衰老的离散疾病； 2）确定障碍和促进因子以提供有效的患者 - 较老的PWH的中心医疗保健。脆弱与艾滋病毒，依赖性和死亡率有关。这是其特征是强度，耐力和功能降低。多种多发性 - 多重互动身心健康状况 - 与艾滋病毒，多药，发病率和死亡率有关。我们假设1）脆弱和多种病的认可和离散的心脏代谢性疾病是在加纳的较老的PWH中被诊断不远； 2）离散心脏代谢的传染病单元转介疾病对他们在加纳的管理无效。为了检验这些假设，我们提出了一个纵向夸梅·恩克鲁玛科学大学的大学医院传染病病房的观察性研究和加纳库马西的技术（knust）。该研究将注册50岁以上的151个PWH 地址三个具体目的：1）在大学护理中，旧PWH的脆弱和多种病态表征医院，诺斯特； 2）评估年龄较大的离散心脏代谢疾病的诊断不足和管理 PWH; 3）确定障碍和促进因素，为老化PWH提供有效的，以患者为中心的医疗保健。 Knust衰老和艾滋病毒成果（KAHO）研究将有助于确定建立的优先事项和机会加纳的艾滋病毒和老年医疗保健的有效综合模型。这种集成的模型将扩大收益在与艾滋病毒衰老的类似情况下，加纳人和其他非洲人的质量预期寿命。