Cognitive Impairment amongst Older Adults with Chronic Medical Conditions and Its Association with Medication Adherence in a Nigerian Tertiary Hospital

Introduction: Older adults constitute a rapidly growing population whose healthcare needs are unique, with a higher prevalence of physical and psychiatric morbidities. A knowledge gap exists on the association between cognitive impairment and medication adherence in older adults with chronic medical conditions. This study examined the association between cognitive impairment and medication adherence amongst older adults with hypertension, diabetes mellitus and arthritis. Methods: A cross-sectional study design was utilised. Three hundred and twenty-seven older adults aged 60 and above were recruited for six months. The socio-clinical pro forma, Community Screening Instrument for Dementia (CSID) and Morisky Medication Adherence Scale-8 were administered. A simple linear regression analysis was done to assess the relationship between medication adherence and cognitive impairment, whereas multiple linear regression was used to control for the effect of confounders on this association. Results: This study found a positive correlation between cognitive functioning and medication adherence, this, however, did not reach statistical significance (β =0.055, P = 0.318). The age of participants, number of medications, duration of illness and number of previous hospitalisations were identified as confounders in the effect of cognitive functioning on medication adherence. The model explained 6.3% of the variance in medication adherence. Using the general linear model, cognitive impairment and diagnosis of medical condition independently predicted medication adherence ( P = 0.026 and P < 0.001, respectively). However, their interaction did not significantly influence medication adherence ( P = 0.311). Conclusion: Cognitive impairment is associated with low medication adherence in older adults with chronic medical conditions. This association is affected by age, chronicity and admissions. This underscores the need for proactive screening of older adults in day-to-day geriatric practice.