{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T09:24:56Z","timestamp":1790846696868,"version":"4.1.0"},"reference-count":46,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2023,2,14]],"date-time":"2023-02-14T00:00:00Z","timestamp":1676332800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000027","name":"National Institute on Alcohol Abuse and Alcoholism","doi-asserted-by":"publisher","award":["U24\u2010AA020794"],"award-info":[{"award-number":["U24\u2010AA020794"]}],"id":[{"id":"10.13039\/100000027","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000027","name":"National Institute on Alcohol Abuse and Alcoholism","doi-asserted-by":"publisher","award":["U01\u2010AA020790"],"award-info":[{"award-number":["U01\u2010AA020790"]}],"id":[{"id":"10.13039\/100000027","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000027","name":"National Institute on Alcohol Abuse and Alcoholism","doi-asserted-by":"publisher","award":["U10 AA013566"],"award-info":[{"award-number":["U10 AA013566"]}],"id":[{"id":"10.13039\/100000027","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["agsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J American Geriatrics Society"],"published-print":{"date-parts":[[2023,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>People 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Using 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\u2013Consumption (AUDIT\u2010C). Medication exposure was measured from 45 to 3\u2009days prior to index date; medications were classified as anticholinergic NCAM, non\u2010anticholinergic 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>PWH experienced a higher incidence of delirium (5.6, [95% CI 5.3\u20135.9\/1000 PY]) than PWoH (5.0, [95% CI 4.8\u20135.1\/1000 PY]). In multivariable analysis, anticholinergic and non\u2010anticholinergic NCAM counts and level of alcohol use demonstrated strong independent dose\u2013response associations with delirium.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Decreasing alcohol use and limiting the use of neurocognitively active medications may help decrease excess rates of delirium, especially among PWH.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jgs.18265","type":"journal-article","created":{"date-parts":[[2023,2,14]],"date-time":"2023-02-14T05:48:10Z","timestamp":1676353690000},"page":"1861-1872","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Delirium among people aging with and without\n                    <scp>HIV<\/scp>\n                    : Role of alcohol and Neurocognitively active medications"],"prefix":"10.1111","volume":"71","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2623-7463","authenticated-orcid":false,"given":"Kathleen M.","family":"Akg\u00fcn","sequence":"first","affiliation":[{"name":"Department of Medicine VA Connecticut Health System West Haven Campus  West Haven Connecticut USA"},{"name":"Department of Internal Medicine Yale University School of Medicine  New Haven Connecticut USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Supriya","family":"Krishnan","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Yale University School of Medicine  New Haven Connecticut USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janet","family":"Tate","sequence":"additional","affiliation":[{"name":"Department of Medicine VA Connecticut Health System West Haven Campus  West Haven Connecticut USA"},{"name":"Department of Internal Medicine Yale University School of Medicine  New Haven Connecticut 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