Supporting Older Adults with Mild Cognitive Impairment in Medication Taking: A 2-year Longitudinal StudyAuthor(s): Angela YM Leung, Selina Lo, Isaac Leung, Justina YW Liu, Sylvia Ting
Objective: Community dwelling older adults with mild cognitive impairment (MCI) encounter challenges in many daily activities including medication taking. With inadequate health literacy, many of them have difficulty in understanding the instructions on drug labels and make decision on medication taking. This study aims to assess the effect of two interventions, verbal advice plus educational leaflet (VAEL) and comic books (CB), on medication taking among persons with MCI.
Methods: This is a two-year multi-site longitudinal study with pre-and-post design and four-point measures (Time 1, 2, 3, and 4). Subjects were aged 60 or above, scored <22 in Chinese version of the Montreal Cognitive Assessment (MoCA), and were taking ≥ 2 drugs regularly. Health literacy was measured by the 24-item Chinese Health Literacy for Chronic Care (CHLCC) and medication adherence was measured by the 8-item Morisky Medication Adherence Scale (MMAS). Generalized Linear Mixed Models (GLMM) and Generalized Estimating Equation (GEE) were used.
Results:Among the 131 subjects, the majority (62%) were females and mean age was 82.5 (SD 6.5). One-third of them received primary education (31%). Controlling age, there was a significant increase in CHLCC scores after the use of CBs (T4-T3: coefficient=2.742, p=0.003;T4-T1: coefficient=5.073, p=0.014). On the other hand, comparing to the baseline at T1 and controlling age, the chance of moving MMAS level one level higher than its original level at T4 was high (O.R.=3.316, S.E. 0.2979, 95% CI 0.650-1.747, p<0.001). Similar improvement in MMAS level was observed at T3 and T2.
Conclusion: The two interventions (VAEL and CBs) seem to be a good strategy to improve health literacyand medication adherence among community dwellers with MCI. More research is warranted to support medication taking in this specific population.