Polypharmacy Is Associated With Falls in Women With and Without HIV

Area of Science:

• Gerontology
• Infectious Diseases
• Pharmacology

Background:

• Aging individuals with HIV face higher risks of neurocognitive impairment, polypharmacy, and falls.
• Polypharmacy, defined as using 5+ non-antiretroviral therapy (ART) medications, is a growing concern.
• Neurocognitive adverse effect (NCAE) medications can exacerbate health issues in aging populations.

Purpose of the Study:

• To assess the associations between polypharmacy, NCAE medication use, and fall risk.
• To compare these associations in women with HIV (WWH) and women without HIV (HIV-).
• To determine if polypharmacy and NCAE medication use independently contribute to fall risk.

Main Methods:

• Utilized semiannual self-reported falls and medication data from 1872 participants (1315 WWH, 557 HIV-) in the Women's Interagency HIV Study (2014-2016).
• Evaluated polypharmacy and NCAE medication use separately and jointly using multivariable models.
• Adjusted for HIV serostatus, study site, sociodemographics, clinical characteristics, and substance use.

Main Results:

• Fall rates were similar (19%) between WWH and HIV- women.
• WWH reported higher rates of polypharmacy (51% vs. 41%) and NCAE medication use (44% vs. 37%) compared to HIV- women.
• Polypharmacy significantly increased odds of single falls (aOR 1.67) and multiple falls (aOR 2.31); NCAE medication use showed similar associations. Both remained independent risk factors for falls.

Conclusions:

• Polypharmacy and NCAE medication use are more prevalent in WWH and independently increase fall risk.
• Deprescribing and avoiding NCAE medications are crucial for reducing fall risk in WWH.
• These findings are relevant for both WWH and sociodemographically similar women without HIV.