{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T14:31:59Z","timestamp":1786977119593,"version":"build-2736575974"},"reference-count":33,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2026,2,22]],"date-time":"2026-02-22T00:00:00Z","timestamp":1771718400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,2,22]],"date-time":"2026-02-22T00:00:00Z","timestamp":1771718400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Br J Clin Pharmacol"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>In ageing people with human immunodeficiency virus (HIV), frailty, multimorbidity and polypharmacy are prevalent. Anticholinergic medications are commonly prescribed in this population and are associated with adverse physical and cognitive outcomes, yet their contribution to frailty phenotypes remains insufficiently characterized.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a cross\u2010sectional study of people with HIV receiving care at a tertiary HIV clinic in Northern Italy. Anticholinergic burden (ACB) was quantified using the Anticholinergic Cognitive Burden scale. Frailty was assessed using the modified Fried phenotype and the deficit\u2010accumulation Rockwood index. Multivariable linear models with interaction terms (IT) and perturbation analyses were used to evaluate independent associations between ACB and frailty scores and to assess effect modification by demographics and clinical factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 1200 participants were included (mean age of 52\u2009\u00b1\u200912\u2009years; 95.5% with HIV\u2010RNA\u2009&lt;\u200950 copies\/mL; 19.0% receiving anticholinergic medications). By Fried criteria, 38.7% were pre\u2010frail and 6.9% frail, with Rockwood score increasing stepwise across these groups. ACB was among the strongest independent correlates of frailty (Fried:\n                      <jats:italic>a\u03b2<\/jats:italic>\n                      0.32 [0.25\u20130.40],\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u2009.001; Rockwood:\n                      <jats:italic>a\u03b2<\/jats:italic>\n                      0.69 [0.61\u20130.77],\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u2009.001), alongside age and chronic kidney disease. With the Fried phenotype, the impact of ACB significantly intensified with age (IT\n                      <jats:italic>a\u03b2<\/jats:italic>\n                      1.17,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u2009.001), prior acquired immunodeficiency syndrome (AIDS) (IT\n                      <jats:italic>a\u03b2<\/jats:italic>\n                      0.35,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u2009.001) events and longer HIV duration (IT\n                      <jats:italic>a\u03b2<\/jats:italic>\n                      0.16,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u2009.023).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>ACB is a modifiable contributor to frailty in people with HIV, with disproportionate impact on older individuals and those with prior severe immunosuppression. Incorporating routine ACB assessment and deprescribing strategies into HIV care may help support functional ageing and reduce vulnerability.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/bcp.70504","type":"journal-article","created":{"date-parts":[[2026,2,23]],"date-time":"2026-02-23T04:16:08Z","timestamp":1771820168000},"page":"2220-2229","source":"Crossref","is-referenced-by-count":3,"title":["Anticholinergic burden interacts with age and AIDS history to amplify frailty in people with HIV"],"prefix":"10.1002","volume":"92","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0263-0703","authenticated-orcid":false,"given":"Maria","family":"Mazzitelli","sequence":"first","affiliation":[{"name":"Infectious and Tropical Diseases Unit Padua University Hospital  Padua Italy"},{"name":"Dipartimento di Sicurezza e Bioetica \u2010 Sezione di Malattie Infettive Universit\u00e0 Cattolica del Sacro Cuore  Rome Italy"},{"name":"Department of Medical and Surgical Sciences Fondazione Policlinico Gemelli  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mattia","family":"Trunfio","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases and Global Health, Department of Medicine University of California San Diego  San Diego California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Davide","family":"Leoni","sequence":"additional","affiliation":[{"name":"Infectious and Tropical Diseases Unit Padua University Hospital  Padua Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lolita","family":"Sasset","sequence":"additional","affiliation":[{"name":"Infectious and Tropical Diseases Unit Padua University Hospital  Padua Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorenza","family":"Barbison","sequence":"additional","affiliation":[{"name":"Psychiatry Unit Padua University Unit  Padua Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela","family":"Favaro","sequence":"additional","affiliation":[{"name":"Psychiatry Unit Padua University Unit  Padua Italy"},{"name":"Department of Molecular Medicine University of Padua  Padua Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuele","family":"Gardin","sequence":"additional","affiliation":[{"name":"Infectious and Tropical Diseases Unit Padua University Hospital  Padua Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacopo","family":"Farina","sequence":"additional","affiliation":[{"name":"Geriatric Unit Padua University Hospital  Padua Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincenzo","family":"Scaglione","sequence":"additional","affiliation":[{"name":"Infectious and Tropical Diseases Unit Padua University Hospital  Padua 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