Disturbed medication management in older adults with good cognitive health and mild cognitive impairment associated...

For older adults with mild cognitive impairment or mild dementia, maintaining daily lives at home is also ideal for quality of life. However, they have serious problems with medication management. Although the Dementia Assessment Sheet in community-based integrated care system-21 items and the regimen comprehension scale are assessment scales for medication, there have been no reports evaluating both semantic memory and actual performance.

A total of 180 older adults aged ≥75 years were entered in the Wakuya Project. They underwent the Clinical Dementia Rating, with two original tests: (i) the original semantic memory task for taking medication including the Dementia Assessment Sheet in community-based integrated care system-21 items; and (ii) the actual performance task related to medication including regimen comprehension scale. Non-demented participants were classified into two groups based on reports from their families; that is, a good management group (n = 66) and a poor management group (n = 42), and the two original tests were analyzed as explanatory variables.

There were no differences between the two groups for the actual performance task related to medication including regimen comprehension scale. The success rates for the actual performance task related to medication including regimen comprehension scale (good management group/poor management group) were: regimen comprehension scale 40.9/23.8, One-Day Calendar 93.9/90.5, Medicine Chest 36.4/23.8 and Sequential Behavior Task 66.7/66.7, respectively. In the original semantic memory task for taking medication including the Dementia Assessment Sheet in community-based integrated care system-21 items, logistic regression analysis showed that only the mechanism of action remained (B -2.38, SE 1.10, Wald 4.69, P-value = 0.03, OR 0.09, 95%CI 0.01-0.80).

Our results suggest that disruption of medicine management might also be associated with drug semantic memory impairment between the two groups, with no difference in general cognitive and executive functions. Geriatr Gerontol Int 2023; 23: 319-325.