Background
Geriatric assessments are becoming increasingly important in HIV clinical practice as the population of older persons with HIV (PWH) expands. However, traditional instruments are often complex and time-consuming. The 10-minute geriatric assessment (10-TaGA) is a rapid, comprehensive assessment developed to screen geriatric syndromes in healthcare settings. We investigated the validity of 10-TaGA among PWH in Brazil.
Methods
The Longitudinal Study of HIV & Aging in Brazil (ELEA-Brasil) enrolled PWH ≥50 years old on antiretroviral therapy for comprehensive clinical, social, and demographic data collection. Participants also completed 10-TaGA, a 10-minute assessment of domains: social support, recent hospitalization, falls, medications, ability to perform self-care activities, cognition, self-rated health, depressive symptoms, nutritional status, and mobility. 10-TaGA performance of individual domains were compared with traditional assessments using Kruskal Wallis tests.Total 10-TaGA score was correlated with Fried Frailty Phenotype (FFP) using the Spearman test. Sensitivity and specificity by 10-TaGA was measured using receiver operating characteristic (ROC) curves analyses and Youden index to define the optimal threshold for frail/prefrail discriminations.
Results
We enrolled 703 PWH with a median age 62 years; 63% were males, 49% were pre-frail and 6% frail. The median time to complete the 10-TaGA was 7.53 minutes (IQR:5.72-9.48). Overall, 10-TaGA scores in the domains of social support, functionality, cognitive status, depressive symptoms, nutritional status, and gait speed had significant association with traditional assessments (p value for all <0.05). Total 10-TaGA scores significantly correlated with FFP (Spearman’s Rho 0.42, 95% confidence interval [CI] 0.35-0.47) and was highly predictive of frailty (area under the ROC curve = 0.94; Figure). Total 10-TaGA score ≥0.3 presented the best balance between sensitivity (93%) and specificity (82%) to detect PWH who are frail..
Conclusions
The 10-TaGA is an efficient, valid instrument for rapid comprehensive geriatric assessment and frailty/prefrailty determination among PWH. Highly applicable in HIV clinical practice, 10-TaGA warrants further investigation as a tool to identify prefrailty/frailty and to prevent adverse health outcomes in older PWH.
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