COGNITIVE DYSFUNCTION ASSOCIATED WITH MEDICATION NONADHERENCE

这个子项目是许多研究子项目中的一个 由NIH/NCRR资助的中心赠款提供的资源。子项目和 研究者（PI）可能从另一个NIH来源获得了主要资金， 因此可以在其他CRISP条目中表示。所列机构为 研究中心，而研究中心不一定是研究者所在的机构。 导致老年患者住院和疗养院入院的一个重要风险因素是处方药不依从性。 对药物的遗忘和困惑是超过三分之一的不依从的原因。 没有经过充分验证的，广泛使用的工具来测试初级保健环境中的药物管理能力。 然而，迫切需要一种方法来识别管理药物的能力差的个体。 同样，我们不清楚与不同类型的药物不依从性相关的认知领域，因此，我们改善药物不依从性的策略可能与原因不匹配。 事实上，很少有策略在提高药物依从性方面非常有效，这可以归因于原因-干预策略不匹配。 了解与管理药物和不依从性的不同能力相关的认知领域将使我们能够将干预策略与不依从性的原因相匹配。 我们的长期目标是制定策略，以提高社区居住的老年人的药物依从性，以尽量减少他们成为住院或需要搬迁到疗养院设施，由于药物使用的错误。 本申请的目的是研究六个认知领域的功能障碍如何影响药物管理能力以及随后的有意和无意的药物不依从性。 我们将比较四种在临床环境中很少使用的工具，以评估药物管理评估，并确定与六种不同认知领域和两种类型的药物不依从性（有意和无意）的关联。 将获得25名老年人的前瞻性数据。 将进行相关性分析。

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.