Structure of the drug treatment adherence in elderly patients with mild cognitive impairment and psychopathological symptoms

Abstract

Background. The high prevalence of pre-dementia cognitive impairment in the elderly, their poor prognosis with a frequent transition to dementia, polymorbidity with somatic pathology determine the need for adequate correction of all somatic diseases. This increases the importance of treatment adherence.

Aim. To assess the structure of drug treatment adherence in elderly patients with mild cognitive impairment (MCI) and psychopathological symptoms.

Material and methods. An observational study of 264 patients diagnosed with mild cognitive impairment was conducted. The average age was 68.5±1.4 years. Of these, 17.6% were men, and 83.3% were women. The patients were divided into two groups: with psychopathological symptoms (main group, n=189) and without psychopathological symptoms (comparison group, n=75). Research methods used: clinical-psychopathological, psychometric, statistical by using Statistica 7 software for Windows OS. The Pearson's chi-squared test, the nonparametric Mann–Whitney U test, and the correlation analysis with calculation of Spearman’s rank correlation coefficient (r) were used.

Results. The adherence (compliance) of the study participants in relation to general therapeutic recommendations is represented by social, emotional and behavioural compliance. The total score of general compliance in the main study group was 45.42±29.7, in the comparison group — 51.09±32.3 points (p=0.031). In the main group, half of the participants (49.7%) had a low total score of general compliance, less than half of the participants had an average total score, only 4.8% of the participants showed high compliance with therapeutic recommendations. Increased depression correlates with low overall, social and emotional competence (r=0.512). Severe agitation and aggression correlate with low behavioural and emotional competence (r=0.589). Statistically significant correlations were found between psychotic symptoms and low behavioural compliance (r=0.151 and r=0.145).

Conclusion. The overall medication compliance rates are lower in patients with affective and psychotic symptoms; an increase in the number of affective, psychotic, behavioural disorders in patients with mild cognitive impairment correlates with low overall, social, emotional and behavioural compliance.

Keywords

mild cognitive impairment / compliance / drug treatment adherence / adherence to therapy

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