ArticleAIDS (London, England)2026
Longitudinal effects of polypharmacy on cognitive function in people with HIV.
Article in AIDS (London, England), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Plasma NfL and sCD14 Are Associated with Polypharmacy and Recurrent Falls in Virally Suppressed Older People with HIV.Journal of acquired immune deficiency syndromes (1999) · 2026Article
- Anticholinergic burden interacts with age and AIDS history to amplify frailty in people with HIV.British journal of clinical pharmacology · 2026Article
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Authors and funding
7 authors.
Funding
Abstract
objectiveTo investigate the relationship of polypharmacy exposure to longitudinal trajectories of global and domain-specific cognitive function in people with HIV (PWH), focusing on the effects of both stable and transitioning polypharmacy regimens.
designLongitudinal analyses.
methodsLongitudinal data from 2173 PWH, including 1017 virally suppressed (VS-PWH), were analyzed using harmonized datasets from the CHARTER, NNTC, and HNRP studies. Polypharmacy was categorized as low (0-4 medications), moderate (5-9), or high (≥10) based on the number of nonantiretroviral therapy (non-ART) medications. Demographically adjusted global and domain-specific T-scores were derived from standardized batteries. To assess the association between polypharmacy and cognitive trajectories, we developed a novel transition-based mixed-effects regression approach that captured both stable and changing patterns of polypharmacy exposure over time, allowing for the assessment of immediate and cumulative cognitive effects of medication burden.
resultsHigher polypharmacy levels were significantly associated with poorer global and domain-specific cognitive function. Participants with high polypharmacy exhibited steeper cognitive declines, while those with low polypharmacy demonstrated stable or modestly improved trajectories. This pattern was similarly observed in VS-PWH. Transitions from low to high polypharmacy resulted in significant global and domain-specific cognitive declines. Conversely, reductions from moderate or high to lower polypharmacy levels yielded cognitive improvements - particularly in motor function - in both PWH and VS-PWH populations.
conclusionPolypharmacy imposes a cumulative burden on cognitive function in both PWH and VS-PWH. Higher polypharmacy levels exacerbate cognitive decline, highlighting the necessity of targeted strategies to manage polypharmacy and mitigate its long-term cognitive impact.
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