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Cognitive Impairment Is Independently Associated with Non-Adherence to Antithrombotic Therapy in Older Patients with

Hyun-Joo Seong1, Kyounghoon Lee2, Bo-Hwan Kim3

  • 1Red Cross College of Nursing, Chung-Ang University, Seoul 06974, Korea.

International Journal of Environmental Research and Public Health
|August 1, 2019
PubMed

Insights

Cognitive impairment, not health literacy, significantly increases stroke risk in older atrial fibrillation (AF) patients due to poor adherence to antithrombotic therapy. Healthcare providers must assess cognition and medication adherence in elderly AF patients.

Area of Science:

  • Cardiology
  • Geriatrics
  • Neuroscience

Background:

  • Atrial fibrillation (AF) patients require oral antithrombotic therapy to mitigate stroke risk.
  • Cognitive impairment and low health literacy are prevalent in older AF patients, potentially leading to treatment non-adherence.
  • Understanding factors influencing adherence is crucial for effective stroke prevention strategies.

Purpose of the Study:

  • To investigate the impact of cognitive impairment and health literacy on non-adherence to antithrombotic therapy in older AF patients.
  • To identify key risk factors for poor medication adherence in this vulnerable population.

Main Methods:

  • Secondary analysis of baseline data from a 2018 cross-sectional survey of 277 older AF patients (≥65 years).
  • Data collected via face-to-face interviews using self-reported questionnaires.
  • Multiple logistic regression analysis was employed to assess the influence of cognitive impairment and health literacy on non-adherence.

Main Results:

  • Over half (50.2%) of the studied AF patients were non-adherent to their antithrombotic therapy.
  • Cognitive impairment was independently associated with a significantly increased risk of non-adherence (OR = 2.628, 95% CI = 1.424-4.848).
  • Health literacy did not show a significant association with antithrombotic therapy non-adherence.

Conclusions:

  • Cognitive impairment is a significant predictor of poor adherence to antithrombotic therapy in elderly patients with AF.
  • Routine assessment of cognitive function and medication adherence is recommended for older AF patients.
  • Further research is needed to explore factors contributing to cognitive decline and non-adherence in this demographic.

Keywords:
agedatrial fibrillationcognitive dysfunctionhealth literacymedication adherence

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