1607Veterans Aging Cohort Study (VACS) Index, Functional Status, and Other Patient Reported Outcomes in Older HIV-positive (HIV+) Adults
Bibliographic record
Abstract
Background. Aging HIV+ patients present challenges to overburdened health systems. To better understand this, we assessed results of comprehensive geriatric screenings in this population. We also hypothesized that age and the Veterans Aging Cohort Study (VACS) index, a validated measure of organ system dysfunction predictive of mortality, would be associated with patient-reported outcomes in older HIV+ patients Methods. Cross-sectional survey-based study performed December 2012 – January 2014 of >50 year old HIV+ patients at two UCSF affiliated San Francisco clinics. We evaluated multiple aspects of four basic functional domains using validated measures: physical function (Activity of Daily Living/ADL, Instrumental ADL/IADL, Falls, Short Physical Performance Battery/SPPB), social support (perceived support, loneliness), mental health (depression, anxiety, post-traumatic stress/PTSD), cognitive function (Montreal Cognitive Assessment/MOCA) as well as adherence. Descriptive statistics and ANOVA analyses assessed associations between these domains with age and VACS Index scores. Results. 359 patients were screened (median age 57; 85% males; 57% Caucasian, 30% African-American, 11% Latino; 72% >high school education). Mean CD4 count was 507 cells/mm3, 83% had undetectable viral load, and 85% were HIV-positive > 10 years. On functional screening, 26% (91) reported difficulty with ≥1 ADL, 39% (136) reported difficulty with ≥1 IADL, and 40% reported falls in the previous year. On cognitive screening, 40% had MOCA scores < 26. In addition, 58% had findings of loneliness, 60% the lowest levels of perceived social support, 55% depression, 50% anxiety, and 12% PTSD. Older age was associated with lower CD4 counts, increased difficulty with IADLs, and chair stand component of SPBB. VACS Index score was associated with IADL and medication adherence. Conclusion. We are the first to report an association between VACS index and functional status in older HIV+ patients. Our surveys also revealed a high prevalence of functional, social and cognitive deficits in this population. More comprehensive assessment tools, incorporating the VACS index, are likely to improve predictive models and management paradigms for older HIV-infected individuals. Disclosures. All authors: No reported disclosures.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".