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

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.