The Association Between Mild Cognitive Impairment and Medication Non-adherence Among Elderly Patients With Chronic Diseases

Xiaoqin He; Xinguo Wang; Bin Wang; Aiyong Zhu

doi:10.7759/cureus.47756

The Association Between Mild Cognitive Impairment and Medication Non-adherence Among Elderly Patients With Chronic Diseases

Cureus. 2023 Oct 26;15(10):e47756. doi: 10.7759/cureus.47756. eCollection 2023 Oct.

Authors

Xiaoqin He^{1

2}, Xinguo Wang^{1

2}, Bin Wang³, Aiyong Zhu^{1

2}

Affiliations

¹ School of Graduate, Shanghai University of Traditional Chinese Medicine, Shanghai, CHN.
² School of Nursing and Health Management, Shanghai University of Medicine and Health Sciences, Shanghai, CHN.
³ Department of Endocrinology and Metabolism, Affiliated Hospital of Qingdao University, Qingdao, CHN.

Abstract

Background: Medication adherence is essential for optimizing treatment outcomes in elderly patients who frequently contend with multiple chronic diseases requiring pharmacological interventions. Mild cognitive impairment (MCI) is a prevalent cognitive disorder among the elderly population, but its impact on medication adherence among elderly patients is still uncertain. This cross-sectional study aimed to investigate the impact of MCI on medication adherence among elderly patients.

Methods: A cross-sectional study of 436 elderly patients with common chronic diseases aged 60 years and above was conducted. Medication adherence was measured using the Morisky Medication Adherence Scale-8 (MMAS-8). MCI was screened, and cognitive status was assessed using the Mini-Mental State Examination (MMSE) questionnaire. Multivariate logistic regression analysis was performed to identify independent risk factors of medication non-adherence.

Results: Among these elderly patients, 212 (48.6%) had poor medication compliance, and 181 (41.5%) had MCI. Preliminary analyses showed a significant association between MCI and medication non-adherence among elderly patients (odds ratio (OR)=3.95, 95% confidence interval (95%CI)=2.63-5.92, P<0.001). Multivariate logistic regression analysis showed that MCI was independently associated with the risk of medication non-adherence among elderly patients (adjusted OR=2.64, 95%CI=1.64-4.24, P<0.001). Additionally, adverse drug reaction and poor evaluation of medication effects were also independently associated with medication non-adherence in elderly patients (P<0.05).

Conclusion: Findings from this cross-sectional study proved the substantial adverse impact of MCI on medication adherence among elderly patients, and MCI was an independently influential factor of medication non-adherence. Identifying the MCI status early and providing interventions to enhance medication adherence are undoubtedly essential for optimizing healthcare outcomes in elderly patients.

Keywords: chronic diseases; elderly; influential factor; medication adherence; mild cognitive impairment.