COGNITIVE DYSFUNCTION ASSOCIATED WITH MEDICATION NONADHERENCE

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This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. A significant risk factor contributing to hospital and nursing home admissions of elderly patients is prescription medication nonadherence. Forgetfulness and confusion regarding medications are the cause of over one-third of all nonadherence. There is no well-validated, widely-used instrument to test for medication management capacity in the primary care setting. Yet, there is a critical need for a method to identify individuals with poor ability to manage their medications. As well, we are not clear about the cognitive domains associated with different types of medication nonadherence, and therefore, our strategies for improving medication nonadherence may not match the cause. In fact, few strategies are highly effective at improving medication adherence and this can be attributed to a cause-intervention strategy mis-match. Understanding the cognitive domains associated with different abilities to manage medicines and nonadherence will allow us to match intervention strategies to the causes of nonadherence. Our long-range goal is to develop strategies to improve medication adherence among community-dwelling older adults, in order to minimize their becoming hospitalized or requiring relocation to nursing home facilities as a result of errors in medication use. The object of this application is to examine how dysfunction in six cognitive domains affects medication management capacity and subsequent intentional and unintentional medication nonadherence. We will compare four instruments that are little-used in clinical settings to assess medication management assessment and determine the associations with six different cognitive domains and two types of medication nonadherence (intentional and unintentional). Prospective data from 25 older adults will be obtained. Correlational analyses will be conducted.