{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T15:13:32Z","timestamp":1779290012504,"version":"3.51.4"},"reference-count":19,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T00:00:00Z","timestamp":1779148800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Viruses"],"abstract":"<jats:p>Background: People living with HIV (PLWH) are increasingly reaching older ages due to the success of antiretroviral therapy. However, aging with HIV is associated with increased risk of multimorbidity, neurocognitive impairment, frailty, psychosocial stress, and functional decline. Multidomain geriatric screening framed within an Age-Friendly 4Ms Framework (Mentation, Medication, Mobility, What Matters Most) and consideration of multi-complexity may help identify aging-related vulnerabilities and guide multidisciplinary care with greater impact on patient outcomes. However, real-world implementation of such programs within HIV clinical settings remains limited. Methods: We conducted a retrospective analysis of adults aged \u226550 years enrolled in a multidisciplinary Healthy Aging Program within a large, integrated HIV care system. Multidomain screening assessments included cognitive evaluation (Montreal Cognitive Assessment), mental health screening (PHQ-2, GAD-2), functional assessment (Katz ADL, Lawton IADL), frailty screening (Edmonton Frail Scale), and intrinsic capacity domains using the WHO Integrated Care for Older People (ICOPE) framework. Screening results, referrals, clinical interventions, and cardiometabolic risk management measures were extracted from clinical program databases and electronic medical records. Results: A total of 317 adults aged \u226550 years completed multidomain screening. Participants had well-controlled HIV infection, with viral suppression in 96.2% and a median CD4 count of 660 cells\/mm3. Despite this, aging-related vulnerabilities were common. Overall, 78.4% of participants had at least one abnormal screening domain. Cognitive impairment was identified in nearly half of individuals screened, including mild impairment in 39.8% and moderate impairment in 8.7%. Functional limitations were identified in 10.1% of participants, while anxiety symptoms were present in 9.5%. Sensory impairments were common, including vision impairment in 36.5% of participants. Polypharmacy was prevalent, with 33.2% of participants prescribed five or more chronic medications. Screening frequently generated multidisciplinary referrals, including behavioral health services (42.3%), social work support (42.9%), and pharmacist-led cardiometabolic risk review (56.8%). Age-stratified analyses demonstrated similar prevalence of screening abnormalities across age groups, including individuals aged 50\u201359 years. Modest improvements in cardiometabolic preventive care were observed during follow-up. Statin utilization increased from 65.6% at baseline to 70.0% at 12 months, and LDL cholesterol declined modestly during the observation period. Conclusions: Multidomain screening integrated into routine HIV care identified a high prevalence of aging-related vulnerabilities among PLWH aged \u226550 years despite excellent virologic control. These findings suggest that aging-related risk in HIV is not adequately captured by chronological age alone and support early, universal implementation of multidomain screening within HIV care models.<\/jats:p>","DOI":"10.3390\/v18050572","type":"journal-article","created":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T14:12:54Z","timestamp":1779286374000},"page":"572","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A Multidisciplinary Healthy Aging Program in Comprehensive HIV Care: Multidomain Screening, Clinical Interventions, and Cardiometabolic Risk Management"],"prefix":"10.3390","volume":"18","author":[{"given":"Steven Y.","family":"Hong","sequence":"first","affiliation":[{"name":"Karin and Dayton Brown, Jr. Division of Infectious Diseases, Northwell Health, New Hyde Park, NY 11030, USA"},{"name":"Northwell Health HIV Service Line Program, Center for AIDS Research and Treatment (CART), Northwell Health, New Hyde Park, NY 11030, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Deborah","family":"Woodley","sequence":"additional","affiliation":[{"name":"Karin and Dayton Brown, Jr. Division of Infectious Diseases, Northwell Health, New Hyde Park, NY 11030, USA"},{"name":"Northwell Health HIV Service Line Program, Center for AIDS Research and Treatment (CART), Northwell Health, New Hyde Park, NY 11030, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Megan","family":"Pao","sequence":"additional","affiliation":[{"name":"Karin and Dayton Brown, Jr. Division of Infectious Diseases, Northwell Health, New Hyde Park, NY 11030, USA"},{"name":"Northwell Health HIV Service Line Program, Center for AIDS Research and Treatment (CART), Northwell Health, New Hyde Park, NY 11030, USA"},{"name":"Ambulatory Pharmacy Services, VIVOHealth Pharmacy, Northwell Health, Lake Success, NY 11042, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Holly","family":"Goetz","sequence":"additional","affiliation":[{"name":"Karin and Dayton Brown, Jr. Division of Infectious Diseases, Northwell Health, New Hyde Park, NY 11030, USA"},{"name":"Northwell Health HIV Service Line Program, Center for AIDS Research and Treatment (CART), Northwell Health, New Hyde Park, NY 11030, USA"},{"name":"Ambulatory Pharmacy Services, VIVOHealth Pharmacy, Northwell Health, Lake Success, NY 11042, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alejandro","family":"Alvarez","sequence":"additional","affiliation":[{"name":"Karin and Dayton Brown, Jr. Division of Infectious Diseases, Northwell Health, New Hyde Park, NY 11030, USA"},{"name":"Northwell Health HIV Service Line Program, Center for AIDS Research and Treatment (CART), Northwell Health, New Hyde Park, NY 11030, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Max","family":"White","sequence":"additional","affiliation":[{"name":"Karin and Dayton Brown, Jr. Division of Infectious Diseases, Northwell Health, New Hyde Park, NY 11030, USA"},{"name":"Northwell Health HIV Service Line Program, Center for AIDS Research and Treatment (CART), Northwell Health, New Hyde Park, NY 11030, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7467-0555","authenticated-orcid":false,"given":"Bruce","family":"Hirsch","sequence":"additional","affiliation":[{"name":"Karin and Dayton Brown, Jr. Division of Infectious Diseases, Northwell Health, New Hyde Park, NY 11030, USA"},{"name":"Northwell Health HIV Service Line Program, Center for AIDS Research and Treatment (CART), Northwell Health, New Hyde Park, NY 11030, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8770-6377","authenticated-orcid":false,"given":"Edith","family":"Burns","sequence":"additional","affiliation":[{"name":"Karin and Dayton Brown, Jr. Division of Infectious Diseases, Northwell Health, New Hyde Park, NY 11030, USA"},{"name":"Northwell Health HIV Service Line Program, Center for AIDS Research and Treatment (CART), Northwell Health, New Hyde Park, NY 11030, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1120-7085","authenticated-orcid":false,"given":"Joseph P.","family":"McGowan","sequence":"additional","affiliation":[{"name":"Karin and Dayton Brown, Jr. Division of Infectious Diseases, Northwell Health, New Hyde Park, NY 11030, USA"},{"name":"Northwell Health HIV Service Line Program, Center for AIDS Research and Treatment (CART), Northwell Health, New Hyde Park, NY 11030, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,5,19]]},"reference":[{"key":"ref_1","first-page":"ofaf045","article-title":"Integrated models of HIV care for aging populations: A global perspective","volume":"12","author":"Smith","year":"2025","journal-title":"Open Forum Infect. Dis."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1120","DOI":"10.1093\/cid\/cir627","article-title":"Premature age-related comorbidities among HIV-infected persons compared with the general population","volume":"53","author":"Guaraldi","year":"2011","journal-title":"Clin. Infect. Dis."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1787","DOI":"10.1093\/cid\/ciu701","article-title":"Cross-sectional comparison of the prevalence of age-associated comorbidities and their risk factors between HIV-infected and uninfected individuals","volume":"59","author":"Schouten","year":"2014","journal-title":"Clin. Infect. Dis."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"810","DOI":"10.1016\/S1473-3099(15)00056-0","article-title":"Future challenges for clinical care of an ageing population infected with HIV: A modelling study","volume":"15","author":"Smit","year":"2015","journal-title":"Lancet Infect. Dis."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"633","DOI":"10.1016\/j.immuni.2013.10.001","article-title":"Systemic effects of inflammation on health during chronic HIV infection","volume":"39","author":"Deeks","year":"2013","journal-title":"Immunity"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"2087","DOI":"10.1212\/WNL.0b013e318200d727","article-title":"HIV-associated neurocognitive disorders persist in the era of potent antiretroviral therapy","volume":"75","author":"Heaton","year":"2010","journal-title":"Neurology"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"833","DOI":"10.1093\/gerona\/glt168","article-title":"Is HIV a model of accelerated or accentuated aging?","volume":"69","author":"Pathai","year":"2014","journal-title":"J. Gerontol. A Biol. Sci. Med. Sci."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"769","DOI":"10.1016\/j.idc.2019.04.005","article-title":"HIV and aging: Reconsidering the approach to management of comorbidities","volume":"33","author":"Erlandson","year":"2019","journal-title":"Infect. Dis. Clin. North Am."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1007\/s11904-010-0041-9","article-title":"HIV and aging: Time for a new paradigm","volume":"7","author":"Justice","year":"2010","journal-title":"Curr. HIV\/AIDS Rep."},{"key":"ref_10","unstructured":"Institute for Healthcare Improvement (2026, January 09). Age-Friendly Health Systems: Guide to Using the 4Ms in the Care of Older Adults. Available online: https:\/\/www.ihi.org."},{"key":"ref_11","unstructured":"World Health Organization (2017). Integrated Care for Older People (ICOPE): Guidelines on Community-Level Interventions to Manage Declines in Intrinsic Capacity, World Health Organization."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"695","DOI":"10.1111\/j.1532-5415.2005.53221.x","article-title":"The Montreal Cognitive Assessment, MoCA: A brief screening tool for mild cognitive impairment","volume":"53","author":"Nasreddine","year":"2005","journal-title":"J. Am. Geriatr. Soc."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1284","DOI":"10.1097\/01.MLR.0000093487.78664.3C","article-title":"The Patient Health Questionnaire-2: Validity of a two-item depression screener","volume":"41","author":"Kroenke","year":"2003","journal-title":"Med. Care"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"317","DOI":"10.7326\/0003-4819-146-5-200703060-00004","article-title":"Anxiety disorders in primary care: Prevalence, impairment, comorbidity, and detection","volume":"146","author":"Kroenke","year":"2007","journal-title":"Ann. Intern. Med."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"276","DOI":"10.1080\/08946560801973168","article-title":"Development and validation of a tool to improve physician identification of elder abuse: The Elder Abuse Suspicion Index (EASI)","volume":"20","author":"Yaffe","year":"2008","journal-title":"J. Elder Abus. Negl."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"914","DOI":"10.1001\/jama.1963.03060120024016","article-title":"Studies of illness in the aged: The index of ADL","volume":"185","author":"Katz","year":"1963","journal-title":"JAMA"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1093\/geront\/9.3_Part_1.179","article-title":"Assessment of older people: Self-maintaining and instrumental activities of daily living","volume":"9","author":"Lawton","year":"1969","journal-title":"Gerontologist"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"526","DOI":"10.1093\/ageing\/afl041","article-title":"Validity and reliability of the Edmonton Frail Scale","volume":"35","author":"Rolfson","year":"2006","journal-title":"Age Ageing"},{"key":"ref_19","first-page":"afac173","article-title":"Worldwide prevalence of mild cognitive impairment among community-dwelling adults aged 50 years and older: A systematic review and meta-analysis","volume":"51","author":"Bai","year":"2022","journal-title":"Age Ageing"}],"container-title":["Viruses"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1999-4915\/18\/5\/572\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T14:19:48Z","timestamp":1779286788000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1999-4915\/18\/5\/572"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,19]]},"references-count":19,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2026,5]]}},"alternative-id":["v18050572"],"URL":"https:\/\/doi.org\/10.3390\/v18050572","relation":{},"ISSN":["1999-4915"],"issn-type":[{"value":"1999-4915","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,19]]}}}