Race differences in change in physical functioning in older male veterans with HIV.

BACKGROUND: Little is known about longitudinal change in physical functioning of older African-American/Black and White HIV-infected persons.

METHODS: We examined up to 10 years of data on African-American (N=1157) and White (N=400) men with HIV infection and comparable HIV-negative men (Ns: 1137, 530), age 50-91 from the Veterans Aging Cohort Study Survey sample. Physical functioning was assessed using the SF-12 physical component summary (PCS) score. Mixed effects models examined association of demographics, health conditions, health behaviors and selected interactions with PCS score; HIV biomarkers were evaluated for HIV-infected persons.

FINDINGS: PCS scores were approximately one standard deviation below that of the general United States population of similar age. Across the four HIV/race groups, over time and through ages 65-75, PCS scores were maintained; differences were not clinically significant. PCS score was not associated with race, or with interactions among age, race, and HIV status. CD4 and viral load counts of African-American and White HIV-infected men were similar. Older age, low socioeconomic status, chronic health conditions and depression, lower body mass index, and smoking, were associated with poorer PCS score in both groups. Exercising and, counter-intuitively, being HIV-infected were associated with better PCS score.

INTERPRETATION: Among these older African-American and White male veterans, neither race nor HIV status was associated with PCS score, which remained relatively stable over time. Chronic disease, depression and lack of exercise were associated with lower PCS score. To maintain independence in this population, attention should be paid to controlling chronic conditions, and emphasizing good health behaviors.