Anticholinergic and Sedative Medications Are Associated With Neurocognitive Performance of Well Treated People With Human Immunodeficiency Virus-Reference-Cited by-同舟云学术

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

Published:2022-09-01 Issue:9 Volume:9 Page:
ISSN:2328-8957
Container-title:Open Forum Infectious Diseases
language:en
Short-container-title:

Author:

Jakeman Bernadette¹²³,Scherrer Alexandra U⁴⁵,Darling Katharine E A⁶,Damas Jose⁶,Bieler-Aeschlimann Melanie⁷,Hasse Barbara⁴,Schlosser Ladina⁸,Hachfeld Anna⁹,Gutbrod Klemens¹⁰,Tarr Philip E¹¹,Calmy Alexandra¹²,Assal Frederic¹³,Kunze Ursula¹⁴,Stoeckle Marcel²³,Schmid Patrick¹⁵,Toller Gianina¹⁶,Rossi Stefania¹⁷,di Benedetto Caroline¹⁸,du Pasquier Renaud⁷,Cavassini Matthias⁶^ORCID,Marzolini Catia²³^ORCID,Cavassini Matthias,Du Pasquier Renaud,Bieler-Aeschlimann Melanie,Nadin Isaure,Brugger Peter,Gutbrod Klemens,Monsch Andreas U,Kunze Ursi,Toller Gianina,Schlosser Ladina,Schwind Marc,Rossi Stefania,Sokolov Arseny,Assal Frederic,Derfuss Tobias,von Arx Sebastian,Eisele Gunter,Bertschi Manuel,Hundsberger Thomas,Oberholzer Michael,Jelcic Illijas,Sacco Leonardo,Du Pasquier Renaud,Calmy Alexandra,Lecompte Thanh Doco,Hachfeld Anna,Kovari Helen,Hasse Barbara,Tarr Philip,Stoeckle Marcel,Fux Christoph,Bernasconi Enos,Benedetto Caroline Di,Schmid Patrick,Darling Katharina,Cavassini Matthias,Scherrer Alexandra,Kusejko Katharina,Vallet Yannick,Sormani Valerie,Damas Jose,Ledergerber Bruno,Locatelli Isabella,Marzolini Catia,Decosterd Laurent,Granziera Cristina,Krueger Gunnar,Meuli Reto,Vargas Maria,

Affiliation:

1. Department of Pharmaceutical Practice and Administrative Sciences, University of New Mexico College of Pharmacy , Albuquerque, New Mexico , USA

2. Department of Medicine, Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, University of Basel , Basel , Switzerland

3. Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, University of Basel , Basel , Switzerland

4. Departments of Medicine and Clinical Research, University Hospital Basel, University of Basel , Basel , Switzerland

5. Institute of Medical Virology, University of Zurich , Zurich , Switzerland

6. Service of Infectious Diseases, Lausanne University Hospital, University of Lausanne , Lausanne , Switzerland

7. Service of Neurology, Department of Neurosciences, University Hospital Lausanne, University of Lausanne , Lausanne , Switzerland

8. Department of Neuropsychology, Neurology Clinic, University Hospital Zurich , Zurich , Switzerland

9. Department of Infectious Diseases, University Hospital Bern, University of Bern , Bern , Switzerland

10. Department of Neurology, University Hospital Bern, University of Bern , Neurozentrum Bern , Switzerland

11. University Department of Medicine, Kantonsspital Bruderholz, University of Basel , Basel , Switzerland

12. Division of Infectious Diseases, University Hospital Geneva, University of Geneva , Geneva , Switzerland

13. Service of Neurology, University Hospital Geneva, University of Geneva , Geneva , Switzerland

14. Memory Clinic, Felix Platter Hospital University Center for Medicine of Aging , Basel , Switzerland

15. Department of Infectious Diseases and Hospital Epidemiology, Cantonal Hospital St. Gallen , St. Gallen , Switzerland

16. Neuropsychology Unit, Department of Neurology, Cantonal Hospital St. Gallen , St. Gallen , Switzerland

17. Neuropsychology and Speech Therapy Unit, Neurocenter of Southern Switzerland, Regional Hospital Lugano , Lugano , Switzerland

18. Division of Infectious Diseases, Regional Hospital Lugano , Lugano , Switzerland

Abstract

Abstract Background 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. Methods 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. Results 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). Conclusions Anticholinergic and sedative medications contribute to NCI. Clinicians need to consider these drugs when assessing NCI in PWH.

Funder

Swiss National Science Foundation

Swiss HIV Cohort Study

Publisher

Oxford University Press (OUP)

Subject

Infectious Diseases,Oncology

Link

https://academic.oup.com/ofid/advance-article-pdf/doi/10.1093/ofid/ofac457/45662245/ofac457.pdf

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