Geriatric Assessment Unit, Haifa and Western Galilee District, Clalit Health Services, Haifa, Israel.
Gerontology. 2010;56(5):491-5. doi: 10.1159/000304738. Epub 2010 Mar 26.
Cognitive decline and dementia are highly prevalent amongst the elderly. Medication management problems are also prevalent in this population. Although both problems coexist, the quantitative association between them has not been comprehensively analyzed.
A prospective cross-sectional study of a successive cohort of 425 patients was performed in a community-based geriatric assessment unit. Personal information, results of cognitive function tests, a diagnosis of dementia and an examination of basic knowledge of the medication regimen were recorded and entered into a patient register at the end of each patient's assessment.
Performance in cognitive function tests was significantly poorer in patients demonstrating lack of basic knowledge of the medication regimen. Mean Mini-Mental State Examination score: 19.1 versus 25.5 (p<0.001); mean number of words recalled on a 3-word recall test: 1.0 versus 1.84 (p<0.001); abnormal clock drawing test: 82 versus 57.7%, respectively (p<0.001). The number of patients diagnosed with dementia was greater among patients who demonstrated lack of basic knowledge of the medication regimen (46.8 vs. 6.9%, respectively; p<0.001).
A strong association between lack of basic knowledge of the medication regimen and cognitive dysfunction was demonstrated in elderly patients referred to a geriatric assessment unit, suggesting that lack of basic knowledge of the medication regimen is indicative of cognitive dysfunction and vice versa.
认知能力下降和痴呆在老年人中非常普遍。药物管理问题在这一人群中也很普遍。尽管这两个问题同时存在,但它们之间的定量关联尚未得到全面分析。
对一个社区为基础的老年评估单位连续的 425 例患者进行了前瞻性横断面研究。记录个人信息、认知功能测试结果、痴呆诊断以及药物治疗方案基本知识检查,并在每位患者评估结束时将其录入患者登记册。
在药物治疗方案基本知识缺乏的患者中,认知功能测试的表现明显较差。简易精神状态检查平均得分:19.1 比 25.5(p<0.001);3 字回忆测试平均回忆单词数:1.0 比 1.84(p<0.001);异常的时钟绘制测试:82 比 57.7%(p<0.001)。在药物治疗方案基本知识缺乏的患者中,被诊断为痴呆的患者人数更多(分别为 46.8%和 6.9%;p<0.001)。
在被转介到老年评估单位的老年患者中,药物治疗方案基本知识缺乏与认知功能障碍之间存在很强的关联,这表明药物治疗方案基本知识缺乏提示认知功能障碍,反之亦然。