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Association between cognitive impairment and medication adherence score, including psychological aspects in older

Takuji Adachi1, Yuki Tsunekawa2, Daisuke Tanimura3

  • 1Department of Integrated Health Sciences, Nagoya University Graduate School of Medicine, 1-1-20 Daiko-minami, Higashi-ku, Nagoya 461-8673, Japan; Department of Rehabilitation, Nagoya Ekisaikai Hospital, 4-66 Syonen-cho, Nakagawa-ku, Nagoya 454-8502, Japan.

Geriatric Nursing (New York, N.Y.)
|March 6, 2025
PubMed

Insights

Older patients with cardiovascular disease and cognitive impairment demonstrate poorer medication adherence. Tailoring information sharing to patient cognitive status is crucial for improving medication compliance.

Area of Science:

  • Gerontology
  • Cardiology
  • Neuroscience

Background:

  • Cardiovascular disease (CVD) is prevalent in older adults.
  • Medication adherence is critical for managing CVD but can be challenging in older populations.
  • Cognitive impairment may negatively impact medication adherence in elderly patients.

Purpose of the Study:

  • To investigate the relationship between cognitive impairment and medication adherence in older patients with CVD.
  • To explore specific domains of medication adherence affected by cognitive status.

Main Methods:

  • An observational study involving 163 older patients hospitalized for CVD.
  • Medication adherence assessed using a 12-item scale (compliance, provider collaboration, information access/use, acceptance).
  • Cognitive impairment identified using the rapid dementia screening test (score ≤ 9).

Main Results:

  • Patients with cognitive impairment exhibited significantly lower overall medication adherence scores (p < 0.001).
  • Significant differences were observed in collaboration with healthcare providers and willingness to access/use medication information.
  • Cognitive impairment was independently associated with reduced medication adherence.

Conclusions:

  • Cognitive impairment is a significant barrier to medication adherence in older adults with cardiovascular disease.
  • Interventions should focus on enhancing provider collaboration and improving access to understandable medication information for cognitively impaired patients.
  • Healthcare providers must adapt communication strategies based on individual patient cognitive function to optimize adherence.

Keywords:
Cardiovascular diseaseCognitive impairmentMedication adherenceOlder patients

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