One-year follow-up of medication management capacity in highly functioning older adults

Abstract

Background: We tested the hypothesis that impairment in the ability to take medication independently predicts early functional decline.

Methods: A 12-month, prospective cohort study was performed at two continuing-care retirement facilities using the Drug Regimen Unassisted Grading Scale (DRUGS). This geriatric screening tool utilizes a stepwise progression of four tasks: (i) identification, (ii) access. (iii) dosage, and (iv) timing.

Results: Forty-seven (86%) of the eligible participants completed the 12-month follow-up assessment; three were transferred to skilled nursing facilities. The mean age at study entry was 84.2+/-5.1 years; 72% of the participants were women, and 68% were college educated. At 12 months there was a decline in the Mini-Mental State Examination (MMSE) score (p = .029), an increase in the timed "Up and Go" test (p = .023), and a decline in the DRUGS score (p .029). Nine (18%) of the participants resided in assisted- versus independent-living situations compared with three participants (5%) at study entry (p = .031). Both 12-month DRUGS score and 12-month self-reported medication management capacity were associated with 12-month MMSE (p = .0001 and p = .019, respectively). Baseline DRUGS score was associated with 12-month MMSE and Geriatric Depression Scale scores (p = .0002 and p = .002, respectively). Both baseline DRUGS score and self-reported medication management capacity were also associated with residence in assisted-living communities at 6 months (p = .029 and p = .040, respectively). MMSE was not associated with any of the clinical outcomes.