Geriatric syndromes (GSs) are clinical conditions frequently observed in older adults, resulting from interactions among physical, psychological, and social factors. They are not classified as specific diseases but are associated with functional decline, loss of autonomy, and reduced quality of life. Among people living with HIV/AIDS (PLWHA), multifactorial conditions related to aging may accelerate the onset of GSs, affecting morbidity, mortality, and healthcare demand. This study aimed to evaluate the prevalence of GSs in a cohort of PLWHA aged ≥ 50 years.

Cross-sectional study using baseline data from a cohort of PLWHA aged ≥ 50 years, including both ART-naïve individuals and those under viral suppression. Data were collected via REDCap. Evaluated GSs included: frailty, measured by Fried phenotype (≥ 1 classified as pre-frail/frail); sarcopenia, defined as body mass index (BMI) < 19 and/or Short Physical Performance Battery (SPPB) score ≤ 9; and neurocognitive impairment, assessed by Montreal Cognitive Assessment (MoCA) < 26. Hospitalization and falls in the last 12 months were analyzed, as well as polypharmacy (≥ 5 medications) and extreme polypharmacy (≥ 10 medications), excluding ART.

Thirty-seven PLWHA were included (7 ART-naïve and 30 under viral suppression). Median age was 61 years; 86% were cisgender men and 51% were mixed-race/Black. Median CD4 T-cell count was 667 cells/mm³, CD4/CD8 ratio 0.93, and nadir 271 cells/mm³. Among those under viral suppression, median infection duration was 20 years, 67% had been on ART ≥10 years, and median BMI was 26 kg/m². Overall prevalence of GSs was 95%, with 81% of participants presenting two or more GSs. Frailty/pre-frailty was found in 41%; low physical performance in 68%, suggesting sarcopenia; probable neurocognitive impairment in 62%, with severe cases (MoCA < 21) in 19%. Hospitalization and fall rates were 8% and 11%, respectively. Polypharmacy occurred in 65%, and extreme polypharmacy in 38%.

The high prevalence of GSs and polypharmacy underscores the need for care models tailored to older PLWHA. As the number of older adults with HIV continues to grow, integrating geriatric assessments into care pathways is essential to identify vulnerabilities and provide individualized interventions that improve quality of life.