Executive function, working memory, and medication adherence among older adults.

The purpose of this study was to investigate the association between cognitive processes and medication adherence among community-dwelling older adults. Ninety-five participants (M = 78 years) completed a battery of cognitive assessments including measures of executive function, working memory, cued recall, and recognition memory. Medication adherence was examined over 8 weeks for one prescribed medicine by use of an electronic medication-monitoring cap. In a simultaneous regression, the composite of executive function and working memory tasks was the only significant predictor (beta =.44, p <.01). Findings suggest that assessments of executive function and working memory can be used to identify community-dwelling older adults who may be at risk for failure to take medicines as prescribed.

[1]  Jason C. Allaire,et al.  Well- and ill-defined measures of everyday cognition: relationship to older adults' intellectual ability and functional status. , 2002, Psychology and aging.

[2]  R. Petersen,et al.  Mild cognitive impairment , 2006, The Lancet.

[3]  N. Raz Aging of the brain and its impact on cognitive performance: Integration of structural and functional findings. , 2000 .

[4]  Nicholas Wymbs,et al.  Age-related declines in prospective memory: behavioral and electrophysiological evidence , 2002, Neuroscience & Biobehavioral Reviews.

[5]  Roger W. Morrell,et al.  Processing of Medical information in Aging Patients : Cognitive and Human Factors Perspectives , 1999 .

[6]  R. D'Agostino,et al.  Blood pressure, hypertension, and age as risk factors for poor cognitive performance. , 1995, Experimental aging research.

[7]  Arthur D. Fisk,et al.  Handbook of human factors and the older adult , 1997 .

[8]  Patrick E. McKnight,et al.  Multivariate modeling of missing data within and across assessment waves. , 2000, Addiction.

[9]  Robert K. Heaton,et al.  Wisconsin Card Sorting Test Manual – Revised and Expanded , 1993 .

[10]  S. Allen,et al.  Acquisition and short-term retention of inhaler techniques require intact executive function in elderly subjects. , 2003, Age and ageing.

[11]  R. Hamman,et al.  Executive Cognitive Abilities and Functional Status Among Community‐Dwelling Older Persons in the San Luis Valley Health and Aging Study , 1998, Journal of the American Geriatrics Society.

[12]  Denise C. Park,et al.  Cognitive Function and Medication Usage in Older Adults , 1994 .

[13]  G. Jay,et al.  Longitudinal Change and Prediction of Everyday Task Competence in the Elderly , 1992, Research on aging.

[14]  F. Craik,et al.  The handbook of aging and cognition , 1992 .

[15]  R. Palmer,et al.  Declining Executive Control in Normal Aging Predicts Change in Functional Status: The Freedom House Study , 2004, Journal of the American Geriatrics Society.

[16]  D. Roter,et al.  Patient adherence to HIV medication regimens: a review of published and abstract reports. , 2002, Patient education and counseling.

[17]  P. Rendell,et al.  Aging and prospective memory: differences between naturalistic and laboratory tasks. , 1999, The journals of gerontology. Series B, Psychological sciences and social sciences.

[18]  D. Clark,et al.  Health literacy predicts medication adherence , 2004 .

[19]  S. Willis,et al.  Dimensionality of everyday problem solving in older adults. , 1995, Psychology and aging.

[20]  O. Spreen,et al.  A Compendium of Neuropsychological Tests: Administration, Norms, and Commentary , 1991 .

[21]  A. d’Arminio Monforte,et al.  Medication adherence among HIV+ adults: Effects of cognitive dysfunction and regimen complexity , 2003, Neurology.

[22]  E. A. Berg,et al.  A simple objective technique for measuring flexibility in thinking. , 1948, The Journal of general psychology.

[23]  S. Folstein,et al.  "Mini-mental state". A practical method for grading the cognitive state of patients for the clinician. , 1975, Journal of psychiatric research.

[24]  Lynn Hasher,et al.  Working Memory, Comprehension, and Aging: A Review and a New View , 1988 .

[25]  Mark A. McDaniel,et al.  Habitual Prospective Memory and Aging: Remembering Intentions and Forgetting Actions , 1998 .

[26]  Dimensionality of Everyday Problem Solving in Older Adults , 1995 .

[27]  K. A. McKibbon,et al.  Systematic review of randomised trials of interventions to assist patients to follow prescriptions for medications , 1996, The Lancet.

[28]  K. Schaie,et al.  Everyday problem solving in older adults: observational assessment and cognitive correlates. , 1995, Psychology and aging.

[29]  M. Gebhard Changes in the attractiveness of activities; the effect of expectation preceding performance. , 1949, Journal of experimental psychology.

[30]  M. Farah,et al.  A unified account of cognitive impairments following frontal lobe damage: the role of working memory in complex, organized behavior. , 1993, Journal of experimental psychology. General.

[31]  Ron Dumont,et al.  Wechsler Memory Scale–Third Edition , 2008 .

[32]  C. Hinkin,et al.  Medication adherence among HIV+ adults , 2002, Neurology.

[33]  A. Hofman,et al.  Impaired cognitive function and compliance with antihypertensive drugs in elderly: The Rotterdam Study , 2001, Clinical pharmacology and therapeutics.

[34]  R. Engle,et al.  Is working memory capacity task dependent , 1989 .

[35]  Randall W Engle,et al.  Working memory, short-term memory, and general fluid intelligence: a latent-variable approach. , 1999, Journal of experimental psychology. General.

[36]  D. Carmelli,et al.  Systolic blood pressure tracking over 25 to 30 years and cognitive performance in older adults. , 1998, Stroke.

[37]  J. Mahoney,et al.  Medication Adherence in Elderly Patients Receiving Home Health Services following Hospital Discharge , 2001, The Annals of pharmacotherapy.

[38]  Linda Loos Scarth The Corsini Encyclopedia of Psychology and Behavioral Science , 2002 .

[39]  D. Royall,et al.  Correlates of disability among elderly retirees with "subclinical" cognitive impairment. , 2000, The journals of gerontology. Series A, Biological sciences and medical sciences.

[40]  Morris Moscovitch,et al.  Memory and working with memory: Evaluation of a component process model and comparisons with other models. , 1994 .

[41]  R. West,et al.  An application of prefrontal cortex function theory to cognitive aging. , 1996, Psychological bulletin.

[42]  F. Craik,et al.  Virtual week and actual week: Age‐related differences in prospective memory , 2000 .

[43]  Mark A McDaniel,et al.  Aging and maintaining intentions over delays: do it or lose it. , 2003, Psychology and aging.

[44]  R. Balkrishnan,et al.  Predictors of medication adherence in the elderly. , 1998, Clinical therapeutics.

[45]  E Leventhal,et al.  Medication Adherence in Rheumatoid Arthritis Patients: Older Is Wiser , 1999, Journal of the American Geriatrics Society.

[46]  D. A. Grant,et al.  A behavioral analysis of degree of reinforcement and ease of shifting to new responses in a Weigl-type card-sorting problem. , 1948, Journal of experimental psychology.

[47]  K Ball,et al.  Attentional Problems and Older Drivers , 1997, Alzheimer disease and associated disorders.

[48]  R. Darlington,et al.  Factor Analysis , 2008 .

[49]  Mark A. McDaniel,et al.  Prospective memory and aging: forgetting intentions over short delays. , 2000 .

[50]  R. Spinks The Prefrontal Cortex: Anatomy, Physiology, and Neuropsychology of the Frontal Lobe, 3rd ed. , 2000 .

[51]  J A Yesavage,et al.  Geriatric Depression Scale. , 1988, Psychopharmacology bulletin.

[52]  M Martin,et al.  Adherence to antihypertensive medications across the life span. , 1997, The Gerontologist.

[53]  H. Spinnler The prefrontal cortex, Anatomy, physiology, and neuropsychology of the frontal lobe, J.M. Fuster. Raven Press, New York (1980), IX-222 pages , 1981 .

[54]  D. Cahn-Weiner,et al.  Tests of Executive Function Predict Instrumental Activities of Daily Living in Community-Dwelling Older Individuals , 2002, Applied neuropsychology.