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Association between cognitive impairment and poor antihypertensive medication adherence in elderly hypertensive patients without dementia

机译：无痴呆的老年高血压患者认知障碍与抗高血压药物依从性差之间的关系

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Adherence to antihypertensive medication is a critical factor to control blood pressure and prevent complications. However, cognitive impairment can negatively affect medication adherence. In this study, we investigated the association between cognitive function and antihypertensive medication adherence among elderly hypertensive patients using the Korean National Health Insurance Service National Sample Cohort Data of the Elderly Cohort. The study included 20,071 elderly hypertensive patients and the prevalence of poor medication adherence to antihypertensive medications was 16.4%. A multivariate logistic regression analysis showed that lower cognitive function was associated with poor medication adherence (adjusted odds ratio 0.980, 95% confidence interval 0.961–0.999). Additionally, high income levels, living in metropolitan areas, and comorbidities (such as stroke, coronary heart disease, diabetes, and dyslipidemia) were positively associated with medication adherence, while patients diagnosed with cancers showed poor medication adherence. Our study demonstrated that cognitive impairment is a possible risk factor for poor antihypertensive medication adherence, even in patients without dementia. Thus, clinicians involved with geriatric care should monitor patients’ cognitive function and medication adherence. And if a patient shows cognitive impairment, clinicians need to educate patients and caregivers about the importance of proper adherence, and consider proper interventions to optimize the cognitive function of elderly patients.
机译：坚持使用降压药是控制血压和预防并发症的关键因素。但是，认知障碍可能会对药物依从性产生负面影响。在这项研究中，我们使用韩国国家健康保险服务全国样本队列数据，调查了老年高血压患者认知功能与降压药物依从性之间的关系。该研究纳入了20,071名老年高血压患者，对降压药物依从性差的患病率为16.4％。多元logistic回归分析显示，较低的认知功能与药物依从性差相关（校正比值比为0.980，95％置信区间为0.961-0.999）。此外，高收入水平，居住在大都市地区以及合并症（如中风，冠心病，糖尿病和血脂异常）与依从性呈正相关，而被诊断患有癌症的患者则依从性较弱。我们的研究表明，即使在没有痴呆症的患者中，认知障碍也是降压药物依从性差的可能危险因素。因此，从事老年护理的临床医生应监测患者的认知功能和药物依从性。而且，如果患者出现认知障碍，则临床医生需要对患者和护理人员进行适当依从性的重要性教育，并考虑采取适当的干预措施来优化老年患者的认知功能。

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