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Published on: October 6, 2016
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Longitudinal effects of polypharmacy on cognitive function in people with HIV
Eero Korpela1, Raha M Dastgheyb2, Scott L Letendre3
1Department of Applied Mathematics and Statistics, Whiting School of Engineering, Johns Hopkins University.
AIDS (London, England)
|October 9, 2025
Summary
Polypharmacy, or the use of multiple medications, negatively impacts cognitive function in people with HIV (PWH). Reducing medication burden can improve cognitive trajectories, especially motor function.
Area of Science:
- Neuroscience
- Pharmacology
- Infectious Diseases
Background:
- Polypharmacy is common in people with HIV (PWH), potentially affecting cognitive health.
- Understanding the longitudinal impact of medication burden on cognition is crucial for PWH management.
Purpose of the Study:
- To investigate the relationship between polypharmacy exposure and cognitive function trajectories in PWH.
- To assess the effects of stable and transitioning polypharmacy regimens on cognitive decline.
Main Methods:
- Longitudinal analysis of 2173 PWH, including virally suppressed (VS-PWH), using harmonized datasets.
- Categorization of polypharmacy (low, moderate, high) based on non-ART medication count.
- Novel transition-based mixed-effects regression to model stable and changing polypharmacy effects on cognitive T-scores.
Main Results:
- Higher polypharmacy levels correlated with poorer global and domain-specific cognitive function in PWH.
- High polypharmacy was linked to steeper cognitive decline, while low polypharmacy showed stable or improved trajectories.
- Transitions to higher polypharmacy caused cognitive decline; reductions in medication burden led to cognitive improvements, particularly in motor function.
Conclusions:
- Polypharmacy imposes a cumulative burden on cognitive function in PWH, including VS-PWH.
- Managing polypharmacy is essential to mitigate long-term cognitive decline and improve outcomes for PWH.
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