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Cognitive impairment tied to poor antihypertensive medication adherence among elderly adults

16 Aug 2018
When is enough really enough for patients in light of the growing shift towards polypharmacy?

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.

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Most Read Articles
5 days ago
Living a sedentary lifestyle may increase the risk of cardiovascular diseases (CVD) even in people with healthy body mass index (BMI), reports a new study.
Radha Chitale, 08 Apr 2016
A trial assessing the implantable CardioFit® device designed to stimulate the parasympathetic nervous system in heart failure patients failed to meet its primary endpoints – reducing the rate of hospitalization due to heart failure or death by any cause.
Roshini Claire Anthony, 12 Apr 2016
Patients with atrial fibrillation (AF) who have the highest stroke risk may not be getting preventive oral anticoagulants (OACs), according to a recent US study.
14 Jun 2017
The use of spot urine appears to be unhelpful in estimating 24-hour urinary sodium excretion at the individual level due to its poor performance with regard to misclassification, according to a recent study.