Poor cognitive inhibition predicts poor medication adherence in bipolar elderly
Poorer cognitive inhibition performance is a significant predictor of low medication adherence in elderly patients of bipolar disorder, according to a recent cross-sectional study from France.
The investigators divided 353 patients (mean age 40.67±12.66 years; 61.8 percent female) with bipolar disorder into two according to age: those between 16 and 46 years (young; n=241), and between 47 and 71 years (old; n=112). Patients who were not on current pharmacological treatment and those with histories of neurological diseases were excluded.
While both groups were statistically similar in most characteristics, the young patients had significantly better performances in the California Verbal Learning Test, trail making test and various subtests of the Wechsler Adult Intelligence Scale.
Multiple stepwise logistic regression analyses showed that the number of hospitalizations (adjusted odds ratio [OR], 0.846; 95 percent CI, 0.742 to 0.964; p=0.012), duration of illness (adjusted OR, 0.937; 0.899 to 0.979; p=0.003) and scores in the Patient Rated Inventory of Side Effects scale (PRISE-M; adjusted OR, 1.082; 1.035 to 1.131; p<0.001) were the independent predictors of poor medication adherence in the young group.
In contrast, the number of hospitalizations (adjusted OR, 0.727; 0.574 to 0.921; p=0.006), PRISE-M scores (adjusted OR, 1.124; 1.035 to 1.220; p=0.005), and Stoop Color and Word Test Interference scores (SCWT; adjusted OR, 0.924; 0.861 to 0.992; p=0.03) were the significant predictors of poor adherence in the old group.
The SCWT measures the cognitive inhibition ability of the participants, or their ability to inhibit a dominant response in favour of a more unusual one, according to researchers.