Association of Depression with Antihypertensive Medication Adherence in Older Adults: Cross-Sectional and Longitudinal Findings from CoSMO

BACKGROUND: Little is known about the associations between depressive symptoms, social support and antihypertensive medication adherence in older adults. PURPOSE: We evaluated the cross-sectional and longitudinal associations between depressive symptoms, social support and antihypertensive medication adherence in a large cohort of older adults. METHODS: A cohort of 2,180 older adults with hypertension was administered questionnaires, which included the Center for Epidemiologic Studies-Depression Scale, the Medical Outcomes Study Social Support Index, and the hypertension-specific Morisky Medication Adherence Scale at baseline and 1 year later. RESULTS: Overall, 14.1% of participants had low medication adherence, 13.0% had depressive symptoms, and 33.9% had low social support. After multivariable adjustment, the odds ratios that participants with depressive symptoms and low social support would have low medication adherence were 1.96 (95% confidence interval (CI) 1.43, 2.70) and 1.27 (95% CI 0.98, 1.65), respectively, at baseline and 1.87 (95% CI 1.32, 2.66) and 1.30 (95% CI 0.98, 1.72), respectively, at 1 year follow-up. CONCLUSION: Depressive symptoms may be an important modifiable barrier to antihypertensive medication adherence in older adults.