Purpose of review
The interaction between fall and fracture
risk factors is an area of increasing clinical relevance, but little information is known about the age-specific issues in bone health unique to HIV-infected adults. The present review will focus on what is known about falls
and fall risk factors among HIV-infected adults, and then review the association between decreased muscle, increased adiposity, and frailty
with both low bone mineral density (BMD) and falls
The rate of falls
among middle-aged HIV-infected adults is similar to that of HIV-uninfected adults 65 years and older. Many of the clinical factors that contribute to low BMD overlap with risk factors for falls
, resulting in a high risk of a serious fall among older adults with the greatest risk for a fracture
. Low muscle mass, increased adiposity and metabolic syndrome, physical function impairment and frailty
, common among older HIV-infected adults, contribute to an increased risk for low BMD and falls
, and subsequently, may increase the risk of fracture
among HIV-infected older adults.
Interventions with dual benefit on reducing fall risk and improving BMD are likely to have the greatest impact on fracture
prevention in the older, HIV-infected adult.