Medication Management Capacity and Its Neurocognitive Correlates in Huntington’s Disease

Abstract

Objective Although medication management is a necessary daily activity for individuals with Huntington’s disease (HD), medication management abilities and their relation to cognitive functioning have not been evaluated. Method Twenty individuals with HD and 20 healthy adults (HA) completed the Medication Management Abilities Assessment (MMAA). Individuals with HD also completed a self-report medication management measure and neuropsychological tests assessing executive function, retrospective memory, and prospective memory. Results Individuals with HD performed significantly poorer and made more undertaking errors on the MMAA as compared to HA. No group differences were found in overtaking errors. In the HD group, significant associations were found between undertaking errors and perceived medication management ability as well as between MMAA task performance and measures assessing prospective memory and executive functions. Conclusions Medication management capacity was negatively affected in individuals with HD and may be associated with difficulty remembering to take medications in the future.

The complementary utility of cognitive testing and the medication management ability assessment in older adults.

“…The MMAA has strong test-retest reliability (intraclass correlation coefficient = 0.96; Patterson et al, 2002) and internal consistency (Kuder-Richardson 20 = 0.81 and 0.88, respectively; Margolis et al, 2018Margolis et al, , 2021, as well as concordance with pharmacy refills, pill counts, self-rated medication adherence, and electronically monitored medication taking behavior (Margolis et al, 2018;Patterson et al, 2002;Pratt et al, 2006). In addition to demonstrated clinical validity in individuals with persistent mental illness (Patterson et al, 2002;Pratt et al, 2006), Huntington's disease (Sumida et al, 2018), Parkinson's disease (Pirogovsky et al, 2014), amnestic MCI (Sumida et al, 2019), and epilepsy (Margolis et al, 2018), our group recently found that the MMAA distinguishes older adults with and without dementia at a sensitivity of 0.78 and a specificity of 0.83 (Margolis et al, 2021).…”

“…Indeed, Chaytor and Schmitter-Edgecombe’s (2003) systematic review on ecological validity in neuropsychology reported that tasks high in verisimilitude tend to have stronger and more consistent veridicality than traditional cognitive testing. The Medication Management Ability Assessment (MMAA; Patterson et al, 2002) is an ecologically valid performance-based test that shows particular promise in gauging functional deficits across clinical populations (Margolis et al, 2018; Patterson et al, 2002; Pirogovsky et al, 2014; Pratt et al, 2006; Sumida et al, 2018). The MMAA is high in both verisimilitude and veridicality, as it is simultaneously face-valid and has shown clinical and criterion validity across multiple clinical populations by several research groups including concordance with pharmacy refills, pill counts, and self-rated adherence (Patterson et al, 2002; Pratt et al, 2006), electronically monitored medication taking behavior (Margolis et al, 2018), and diagnostic utility in dementia evaluations (Margolis et al, 2021).…”