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Updated: Nov 18, 2025

A Machine Learning Approach to Design an Efficient Selective Screening of Mild Cognitive Impairment
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A Machine Learning Approach to Design an Efficient Selective Screening of Mild Cognitive Impairment

Published on: January 11, 2020

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Subtle Changes in Medication-taking Are Associated With Incident Mild Cognitive Impairment

Katherine E Dorociak1, Nora Mattek2,3, John E Ferguson4,5

  • 1Palo Alto VA Health Care System, Palo Alto, CA.

Alzheimer Disease and Associated Disorders
|February 4, 2021
PubMed
Abstract

Insights

Older adults who transitioned to mild cognitive impairment (MCI) showed delayed and more variable medication-taking habits. This unobtrusive monitoring can detect early signs of cognitive decline in daily living activities.

Area of Science:

  • Gerontology
  • Neuroscience
  • Cognitive Science

Background:

  • Medication adherence is a crucial daily activity for older adults.
  • Mild cognitive impairment (MCI) significantly impacts daily living activities, including medication management.
  • Current clinical tools struggle to accurately measure medication-taking changes associated with cognitive decline.

Purpose of the Study:

  • To investigate medication-taking patterns in older adults transitioning from normal aging to MCI.
  • To assess the utility of in-home, unobtrusive monitoring for detecting early cognitive changes.

Main Methods:

  • A prospective longitudinal study followed 64 cognitively intact older adults (mean age 85.5 years) for 2.3 years.
  • Instrumented pillboxes tracked daily, weekly, and monthly medication-taking metrics.
  • Nine participants transitioned to MCI during the study period.

Main Results:

  • Participants who developed MCI opened pillboxes later (19 min/month) and showed increased day-to-day variability (4 min/month) compared to stable participants.
  • These medication-taking changes were evident before and after MCI diagnosis.
  • Statistical significance was observed for both later pillbox opening (P<0.001) and increased variability (P=0.003).

Conclusions:

  • Individuals transitioning to MCI exhibit altered medication-taking behaviors, characterized by delays and increased variability.
  • Unobtrusive, in-home monitoring of medication adherence is an ecologically valid method for identifying early functional changes indicative of MCI.
  • This approach offers a promising tool for early detection and intervention in cognitive decline.

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