Anticholinergic and Sedative Medications Are Associated With Neurocognitive Performance of Well Treated People With Human Immunodeficiency Virus.


Jakeman, Bernadette ORCID: 0000-0002-5849-9110, Scherrer, Alexandra U, Darling, Katharine EA, Damas, Jose, Bieler-Aeschlimann, Melanie, Hasse, Barbara, Schlosser, Ladina, Hachfeld, Anna, Gutbrod, Klemens, Tarr, Philip E et al (show 12 more authors) (2022) Anticholinergic and Sedative Medications Are Associated With Neurocognitive Performance of Well Treated People With Human Immunodeficiency Virus. Open forum infectious diseases, 9 (9). ofac457-.

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Abstract

<h4>Background</h4>We previously showed that anticholinergic (ACH) medications contribute to self-reported neurocognitive impairment (NCI) in elderly people with human immunodeficiency virus (PWH). The current cross-sectional study further evaluated the effect of ACH and sedative drugs on neurocognitive function in PWH who underwent comprehensive neuropsychological evaluation.<h4>Methods</h4>A medication review was performed in PWH enrolled in the prospective Neurocognitive Assessment in Metabolic and Aging Cohort within the Swiss HIV Cohort Study. Neurocognitive functions were analyzed in 5 domains (motor skills, speed of information, attention/working memory, executive functions, and verbal learning memory). The effect of ACH and sedative medications on neurocognitive functioning was evaluated using linear regression models for the continuous (mean z-score) outcome and multivariable logistic regression models for the binary (presence/absence) outcome.<h4>Results</h4>A total of 963 PWH (80% male, 92% Caucasian, 96% virologically suppressed, median age 52) were included. Fourteen percent of participants were prescribed ≥1 ACH medication and 9% were prescribed ≥1 sedative medication. Overall, 40% of participants had NCI. Sedative medication use was associated with impaired attention/verbal learning and ACH medication use with motor skills deficits both in the continuous (mean z-score difference -0.26 to -0.14, <i>P</i> < .001 and <i>P</i> = .06) and binary (odds ratio [OR], ≥1.67; <i>P</i> < .05) models. Their combined use was associated with deficits in overall neurocognitive functions in both models (mean z-score difference -0.12, <i>P</i> = .002 and OR = 1.54, <i>P</i> = .03). These associations were unchanged in a subgroup analysis of participants without depression (<i>n</i> = 824).<h4>Conclusions</h4>Anticholinergic and sedative medications contribute to NCI. Clinicians need to consider these drugs when assessing NCI in PWH.

Item Type: Article
Uncontrolled Keywords: NAMACO Study Group, a Swiss HIV Cohort Study
Divisions: Faculty of Health and Life Sciences
Faculty of Health and Life Sciences > Institute of Systems, Molecular and Integrative Biology
Depositing User: Symplectic Admin
Date Deposited: 29 Feb 2024 09:05
Last Modified: 29 Feb 2024 09:05
DOI: 10.1093/ofid/ofac457
Open Access URL: https://doi.org/10.1093/ofid/ofac457
Related URLs:
URI: https://livrepository.liverpool.ac.uk/id/eprint/3178982
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