The interplay of comorbidity, disability, and physical activity among older adults living with HIV: insights from the CHANGE HIV study

Abstract Background Advances in treatment and care have extended the life expectancy of people living with HIV. Nevertheless, comorbidities are common and may result in health-related challenges, known as disability, in everyday life. Rehabilitation strategies such as physical activity may help to mitigate disability. Our aim was to characterize comorbidity profiles and examine their relationship with disability and physical activity among a cohort of older adults living with HIV in Canada. Methods We conducted a cross-sectional analysis of data collected from older adults living with HIV aged 65 years and older and enrolled in the Correlates of Healthy Aging in Geriatric HIV (CHANGE HIV) study. We examined the presence of 14 individual comorbidities and their combinations. Hierarchical linear regression was used to assess the associations between number of comorbidities, disability (Stanford Health Assessment Questionnaire Disability Index), and physical activity (Rapid Assessment of Physical Activity Aerobic Scale) while sequentially adjusting for intrinsic (personal attributes) and extrinsic (perceived HIV stigma and social support) contextual factors. Results Among the 516 participants (median age = 69 years, 25th − 75th percentiles: 67–73), most were identified as male (90%) and White (77%). Participants reported a median of two comorbidities (25th − 75th percentiles: 1–4) in addition to HIV. The most common comorbidities included dyslipidemia (51%), hypertension (45%), cancer (28%), diabetes (23%), and arthritis (21%). Various combinations of coexisting comorbidities were also observed. A greater number of comorbidities was associated with more severe disability scores (ρ = 0.25, p < 0.001). However, higher levels of physical activity attenuated the impact of each additional comorbidity on disability scores, and this moderating effect remained robust after accounting for the influence of intrinsic and extrinsic contextual factors. Conclusions Comorbidities are prevalent among older adults living with HIV in Canada and are associated with disability. Physical activity attenuated the negative association between comorbidity and disability, highlighting that older adults living with HIV who are physically active may experience better functional outcomes. Routine screening and management of chronic conditions, coupled with tailored physical activity interventions, may have a role in addressing disability among older adults living with HIV. Trial registration Clinical trial not applicable.