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Cognition and drug adherence to oral hypoglycemic and antihypertensive agents in older adults

Background and objectives: Chronic disorders such as diabetes mellitus type II and hypertension have been associated with cognitive decline in older adults. It is unclear whether adherence to antihypertensive and oral hypoglycemic agents impact cognitive health. The objectives are to study the assoc...

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Autores principales: Bakouni, Hamzah, Gentil, Lia, Vasiliadis, Helen-Maria
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6551588/
https://www.ncbi.nlm.nih.gov/pubmed/31239647
http://dx.doi.org/10.2147/PPA.S195756
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author Bakouni, Hamzah
Gentil, Lia
Vasiliadis, Helen-Maria
author_facet Bakouni, Hamzah
Gentil, Lia
Vasiliadis, Helen-Maria
author_sort Bakouni, Hamzah
collection PubMed
description Background and objectives: Chronic disorders such as diabetes mellitus type II and hypertension have been associated with cognitive decline in older adults. It is unclear whether adherence to antihypertensive and oral hypoglycemic agents impact cognitive health. The objectives are to study the association between adherence to antihypertensive and oral hypoglycemic agents and cognitive status in community-living older adults. Methods: We used data from a large representative sample of older adults (N=2,286) covered under a public drug insurance plan in Quebec and participating in Quebec’s health survey on older adults (ESA-study) with a Mini-Mental State Examination (MMSE) score ≥22 at baseline (T1) and examined one year later (T2). Participants with hypertension and diabetes mellitus type II were identified according to criteria used in the Canadian Chronic Disease Surveillance System. Antihypertensive and oral hypoglycemic prescriptions delivered were ascertained via Quebec’s pharmaceutical database (RAMQ). Medication adherence was calculated using the medication possession ratio as a continuous variable in the year prior to and following baseline interview. Multivariate linear regressions were used to study the percentage change in MMSE scores between interviews (T1,T2) as a function of adherence to antihypertensive and oral hypoglycemic agents (before and after T1) controlling for potential confounders. Results: In participants with diabetes mellitus type II only, adherence to oral hypoglycemics was not associated with a change in MMSE scores. In participants with hypertension only, the change in MMSE scores was associated with adherence to antihypertensives (β 1.23; 95%CI: 0.29–2.17). In participants with comorbid hypertension and diabetes mellitus type II, the change in MMSE scores was associated with adherence to both antihypertensive and oral hypoglycemic agents (β 0.75; 95%CI: 0.01–1.48). Conclusions: Adherence to oral hypoglycemic agents and antihypertensive agents among older adults with hypertension and comorbid diabetes mellitus type II can have a preserving effect on cognitive health in older adults. Further research on the long-term impact on cognition is recommended.
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spelling pubmed-65515882019-06-25 Cognition and drug adherence to oral hypoglycemic and antihypertensive agents in older adults Bakouni, Hamzah Gentil, Lia Vasiliadis, Helen-Maria Patient Prefer Adherence Original Research Background and objectives: Chronic disorders such as diabetes mellitus type II and hypertension have been associated with cognitive decline in older adults. It is unclear whether adherence to antihypertensive and oral hypoglycemic agents impact cognitive health. The objectives are to study the association between adherence to antihypertensive and oral hypoglycemic agents and cognitive status in community-living older adults. Methods: We used data from a large representative sample of older adults (N=2,286) covered under a public drug insurance plan in Quebec and participating in Quebec’s health survey on older adults (ESA-study) with a Mini-Mental State Examination (MMSE) score ≥22 at baseline (T1) and examined one year later (T2). Participants with hypertension and diabetes mellitus type II were identified according to criteria used in the Canadian Chronic Disease Surveillance System. Antihypertensive and oral hypoglycemic prescriptions delivered were ascertained via Quebec’s pharmaceutical database (RAMQ). Medication adherence was calculated using the medication possession ratio as a continuous variable in the year prior to and following baseline interview. Multivariate linear regressions were used to study the percentage change in MMSE scores between interviews (T1,T2) as a function of adherence to antihypertensive and oral hypoglycemic agents (before and after T1) controlling for potential confounders. Results: In participants with diabetes mellitus type II only, adherence to oral hypoglycemics was not associated with a change in MMSE scores. In participants with hypertension only, the change in MMSE scores was associated with adherence to antihypertensives (β 1.23; 95%CI: 0.29–2.17). In participants with comorbid hypertension and diabetes mellitus type II, the change in MMSE scores was associated with adherence to both antihypertensive and oral hypoglycemic agents (β 0.75; 95%CI: 0.01–1.48). Conclusions: Adherence to oral hypoglycemic agents and antihypertensive agents among older adults with hypertension and comorbid diabetes mellitus type II can have a preserving effect on cognitive health in older adults. Further research on the long-term impact on cognition is recommended. Dove 2019-05-30 /pmc/articles/PMC6551588/ /pubmed/31239647 http://dx.doi.org/10.2147/PPA.S195756 Text en © 2019 Bakouni et al. http://creativecommons.org/licenses/by-nc/3.0/ This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php).
spellingShingle Original Research
Bakouni, Hamzah
Gentil, Lia
Vasiliadis, Helen-Maria
Cognition and drug adherence to oral hypoglycemic and antihypertensive agents in older adults
title Cognition and drug adherence to oral hypoglycemic and antihypertensive agents in older adults
title_full Cognition and drug adherence to oral hypoglycemic and antihypertensive agents in older adults
title_fullStr Cognition and drug adherence to oral hypoglycemic and antihypertensive agents in older adults
title_full_unstemmed Cognition and drug adherence to oral hypoglycemic and antihypertensive agents in older adults
title_short Cognition and drug adherence to oral hypoglycemic and antihypertensive agents in older adults
title_sort cognition and drug adherence to oral hypoglycemic and antihypertensive agents in older adults
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6551588/
https://www.ncbi.nlm.nih.gov/pubmed/31239647
http://dx.doi.org/10.2147/PPA.S195756
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