Cognitive impairment tied to poor antihypertensive medication adherence among elderly adults
Cognitive impairment appears to be a risk factor for poor adherence to antihypertensive medication among elderly adults without dementia, a recent study has shown.
The study included 20,071 elderly hypertensive adults without a history of dementia (≥60 years; 54.3 percent female), of whom 16.4 percent (n=3,297) were poorly compliant with antihypertensive medication.
Multivariate logistic regression analysis showed that low cognitive function was associated with poor medication adherence, such that each increment in the Prescreening Korean Dementia Screening Questionnaire was associated with a significant drop in the likelihood of good adherence (adjusted odds ratio [OR], 0.980; 96 percent CI, 0.961–0.999; p=0.042).
The presence of comorbidities, such as stroke (adjusted OR, 1.351; 1.151–1.585; p<0.001), coronary heart disease (adjusted OR, 1.501; 1.330–1.694; p<0.001), diabetes (adjusted OR, 1.639; 1.492–1.800; p<0.001) and dyslipidaemia (adjusted OR, 1.533; 1.388–1.693; p<0.001), was associated with better medication adherence.
In contrast, being diagnosed with cancer appeared to increase the likelihood of poor adherence (adjusted OR, 0.802; 0.686–0.939; p=0.006).
Sex (female vs male: adjusted OR, 0.929; 0.860–1.004; p=0.063) and scores in the Geriatric Depression Scale (adjusted OR, 0.988; 0.947–1.031; p=0.584) were unrelated to the risk of poor antihypertensive medication adherence.
“[C]linicians involved with geriatric care should monitor patients’ cognitive function and medication adherence. If a patient shows cognitive impairment, clinicians need to educate both the patient and caregiver about the importance of proper adherence. Clinicians should also consider interventions that optimize the cognitive function of elderly patients,” said researchers.