Supporting older adults with mild cognitive impairment in medication taking: A 2-year longitudinal study

Angela Yee Man Leung (Corresponding Author), Selina Lo, Sze Him Isaac Leung, Yat Wa Justina Liu, Shuk Man Sylvia Ting

Research output: Journal article publicationJournal articleAcademic researchpeer-review

Abstract

Objective:
Community dwelling older adults with mild cognitive impairment (MCI) encounter challenges
in many daily activities including medication taking. With inadequate health literacy, many of them have difficulty in understanding the instructions on drug labels and make decision on medication taking. This study aims to assess the effect of two interventions, verbal advice plus educational leaflet (VAEL) and comic books (CB), on medication taking among persons with MCI.

Methods:
This is a two-year multi-site longitudinal study with pre-and-post design and four-point
measures (Time 1, 2, 3, and 4). Subjects were aged 60 or above, scored <22 in Chinese version
of the Montreal Cognitive Assessment (MoCA), and were taking ≥ 2 drugs regularly. Health literacy was measured by the 24-item Chinese Health Literacy for Chronic Care (CHLCC) and medication adherence was measured by the 8-item Morisky Medication Adherence Scale (MMAS). Generalized Linear Mixed Models (GLMM) and Generalized Estimating Equation (GEE) were used.

Results:
Among the 131 subjects, the majority (62%) were females and mean age was 82.5 (SD 6.5). One-third of them received primary education (31%). Controlling age, there was a significant increase in CHLCC scores after the use of CBs (T4-T3: coefficient=2.742, p=0.003; T4-T1: coefficient=5.073, p=0.014). On the other hand, comparing to the baseline at T1 and controlling age, the chance of moving MMAS level one level higher than its original level at T4 was high (O.R.=3.316, S.E. 0.2979, 95% CI 0.650-1.747, p<0.001). Similar improvement in MMAS level was observed at T3 and T2.

Conclusion:
The two interventions (VAEL and CBs) seem to be a good strategy to improve health literacy
and medication adherence among community dwellers with MCI. More research is warranted
to support medication taking in this specific population.
Original languageEnglish
Pages (from-to)816-821
Number of pages6
JournalNeuropsychiatry (London)
Volume7
Issue number6
DOIs
Publication statusPublished - 2017

Keywords

  • medication
  • mild cognitive impairment
  • older adults
  • longitudinal study
  • medication adherence
  • health literacy

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