Medication adherence in healthy elders: Small cognitive changes make a big difference

Objective: This was a cross-sectional study of the ability of independently living healthy elders to follow a medication regimen. Participants were divided into a group with High Cognitive Function (HCF) or Low Cognitive Function (LCF) based on their scores on the ADAS-Cog. Method: Thirty-eight participants aged 65 or older and living independently in the community followed a twice-daily vitamin C regimen for 5 weeks. Adherence was measured using an electronic 7-day pillbox. Results: The LCF group had significantly poorer total adherence than the HCF group (LCF: 63.9 ± 11.2%, HCF: 86.8 ± 4.3%, t ₃₆ = 2.57, p =.007), and there was a 4.1 relative risk of non-adherence in the LCF group as compared to the HCF group. Discussion: This study has important implications for the conduct of clinical drug trials, as it provides strong evidence that even very mild cognitive impairment in healthy elderly has a detrimental impact on medication adherence.