Anticholinergic and Sedative Medications Are Associated With Neurocognitive Performance of Well Treated People With Human Immunodeficiency Virus.
Details
State: Public
Version: Final published version
License: CC BY-NC-ND 4.0
Serval ID
serval:BIB_06A5B894B7FF
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Anticholinergic and Sedative Medications Are Associated With Neurocognitive Performance of Well Treated People With Human Immunodeficiency Virus.
Journal
Open forum infectious diseases
Working group(s)
NAMACO Study Group, a Swiss HIV Cohort Study
Contributor(s)
Cavassini M., Du Pasquier R., Bieler-Aeschlimann M., Nadin I., Brugger P., Gutbrod K., Monsch A.U., Kunze U., Toller G., Schlosser L., Schwind M., Rossi S., Sokolov A., Assal F., Derfuss T., von Arx S., Eisele G., Bertschi M., Hundsberger T., Oberholzer M., Jelcic I., Sacco L., Du Pasquier R., Calmy A., Lecompte T.D., Hachfeld A., Kovari H., Hasse B., Tarr P., Stoeckle M., Fux C., Bernasconi E., Benedetto C.D., Schmid P., Darling K., Cavassini M., Scherrer A., Kusejko K., Vallet Y., Sormani V., Damas J., Ledergerber B., Locatelli I., Marzolini C., Decosterd L., Granziera C., Krueger G., Meuli R., Vargas M.
ISSN
2328-8957 (Print)
ISSN-L
2328-8957
Publication state
Published
Issued date
09/2022
Peer-reviewed
Oui
Volume
9
Number
9
Pages
ofac457
Language
english
Notes
Publication types: Journal Article
Publication Status: epublish
Publication Status: epublish
Abstract
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.
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.
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, P < .001 and P = .06) and binary (odds ratio [OR], ≥1.67; P < .05) models. Their combined use was associated with deficits in overall neurocognitive functions in both models (mean z-score difference -0.12, P = .002 and OR = 1.54, P = .03). These associations were unchanged in a subgroup analysis of participants without depression (n = 824).
Anticholinergic and sedative medications contribute to NCI. Clinicians need to consider these drugs when assessing NCI in PWH.
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.
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, P < .001 and P = .06) and binary (odds ratio [OR], ≥1.67; P < .05) models. Their combined use was associated with deficits in overall neurocognitive functions in both models (mean z-score difference -0.12, P = .002 and OR = 1.54, P = .03). These associations were unchanged in a subgroup analysis of participants without depression (n = 824).
Anticholinergic and sedative medications contribute to NCI. Clinicians need to consider these drugs when assessing NCI in PWH.
Keywords
HIV, anticholinergic medication, neuro-HIV, neurocognitive impairment, sedative medication
Pubmed
Web of science
Open Access
Yes
Funding(s)
Swiss National Science Foundation / 192777
Create date
04/10/2022 10:19
Last modification date
06/08/2024 6:08
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