ArticleJournal of the American Geriatrics Society2023
Delirium among people aging with and without HIV: Role of alcohol and Neurocognitively active medications.
Article in Journal of the American Geriatrics Society, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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The trial behind it
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Who cites it
7 citing papers in PubMed.
- Concurrent Alcohol Use and the Relative Risk of Community-Acquired Pneumonia Associated With Anticholinergic and Non-Anticholinergic Neurocognitively Active Medication Receipt: A National Nested Case-Control Study Among US Veterans.Pharmacoepidemiology and drug safety · 2025Article
- Alcohol use disorder, but not current alcohol use is associated with falls among people with HIV in care.AIDS (London, England) · 2025Article
- Article
- Alcohol Use and Its Associations With Frailty, Fractures, and Falls Among Older Adults With HIV.Alcohol research : current reviews · 2025Review
- Incidence and contributing factors of dementia among people living with HIV in British Columbia, Canada, from 2002 to 2016: a retrospective cohort study.BMJ public health · 2024Article
- Contingency management with stepped care for unhealthy alcohol use among individuals with HIV: Protocol for a randomized controlled trial.Contemporary clinical trials · 2023Article
- Combining Charlson comorbidity and VACS indices improves prognostic accuracy for all-cause mortality for patients with and without HIV in the Veterans Health Administration.Frontiers in medicine · 2023Article
Corrections and comments
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Authors and funding
11 authors.
Funding
Abstract
backgroundPeople aging with and without HIV (PWH and PWoH) want to avoid neurocognitive dysfunction, especially delirium. Continued use of alcohol in conjunction with neurocognitively active medications (NCAMs) may be a largely underappreciated cause, especially for PWH who experience polypharmacy a decade earlier than PWoH. We compare absolute and relative risk of delirium among PWH and PWoH by age, level of alcohol use, and exposure to NCAMs.
methodsUsing the VACS cohort, we compare absolute and relative risk of inpatient delirium among PWH and PWoH by age, level of alcohol use, and exposure to NCAMs between 2007 and 2019. We matched each case based on age, race/ethnicity, sex, HIV, baseline year, and observation time with up to 5 controls. The case/control date was defined as date of admission for cases and the date corresponding to the same length of time on study for controls. Level of alcohol use was defined using Alcohol Use Disorder Identification Test-Consumption (AUDIT-C). Medication exposure was measured from 45 to 3 days prior to index date; medications were classified as anticholinergic NCAM, non-anticholinergic NCAM, or non NCAM and counts generated. We used logistic regression to determine odds ratios (ORs) for delirium associated with medication counts stratified by HIV status and adjusted for demographics, severity of illness, and related diagnoses.
resultsPWH experienced a higher incidence of delirium (5.6, [95% CI 5.3-5.9/1000 PY]) than PWoH (5.0, [95% CI 4.8-5.1/1000 PY]). In multivariable analysis, anticholinergic and non-anticholinergic NCAM counts and level of alcohol use demonstrated strong independent dose-response associations with delirium.
conclusionsDecreasing alcohol use and limiting the use of neurocognitively active medications may help decrease excess rates of delirium, especially among PWH.
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