Methods: The study design was descriptive and cross-sectional as part of baseline measures from a randomized controlled study. Fifty-three older PLHIV completed baseline measures between September 2014 and November 2015. Fatigue, lack of energy and other symptoms were assessed using self-report measures. The data were analyzed using correlations and multiple linear regression.
Results: The majority of the participants were male (70%) and Caucasian (56%) with a mean age of 57 years. Fatigue and lack of energy were associated with each other, and both symptoms were associated with race, anxiety, depression, and lower cognitive function; but only fatigue was also associated with lower physical function, shorter sleep duration, and more daytime sleepiness. Even after controlling for demographic, physiologic and psychological factors, physical function was negatively associated with fatigue in older people living with HIV/AIDS; meaning that higher physical function was associated with lower fatigue. The association between fatigue and low physical function was correlational rather than causal. Yet findings from this study would suggest that interventions to increase physical functioning and activity, rather than interventions such as daytime rest or naps, would reduce the perception of fatigue older adults living with HIV/AIDS. Depressive symptoms were positively associated with fatigue and lack of energy. African Americans reported less fatigue and more energy compared to other race groups.
Conclusions: This study highlights the importance of increasing physical functioning and activity among older PLHIV to improve fatigue and low energy symptoms. An activity program may benefit more in this population, than encouraging more rest to relieve the symptoms. Future research should address mental health issues such as anxiety and depression, among older people living with HIV/AIDS when intervening to reduce fatigue and lack of energy. Nurses should be aware of race differences in self-perceived fatigue and lack of energy when providing care for older HIV patients. Rather than assuming that low CD4 cell count, anemia or low hemoglobin is responsible for fatigue and low energy in this population, clinicians providing care for older HIV patients should assess for anxiety and depression as well as day-time physical functioning, physical activity, and short sleep duration when implementing a treatment plan for older HIV patients to cope with fatigue.