Medication Management Performance and Associated Cognitive Correlates in Healthy Older Adults and Older Adults with aMCI

Abstract

Although these results present promising potential for the MMAA as a measure of medication management in a clinical setting, further studies need to examine the validity of the MMAA against real-world adherence measures.

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

“…Specifically, individuals with HD performed significantly worse on the total MMAA score and committed more magnitude error and total undertaking magnitude errors when compared with HA, but there was no difference in overtaking errors. Findings are consistent with prior studies examining MMAA performance in other populations, which reported that PD with MCI and older adults with aMCI performed worse than cognitively HA on the MMAA total score (Pirogovsky et al, 2014;Sumida et al, 2018). Interestingly, unlike individuals with aMCI who made significantly more overtaking and undertaking errors (Sumida et al, 2018), in the present study, individuals with HD only made significantly more undertaking magnitude errors when compared to HA.…”

“…Findings are consistent with prior studies examining MMAA performance in other populations, which reported that PD with MCI and older adults with aMCI performed worse than cognitively HA on the MMAA total score (Pirogovsky et al, 2014;Sumida et al, 2018). Interestingly, unlike individuals with aMCI who made significantly more overtaking and undertaking errors (Sumida et al, 2018), in the present study, individuals with HD only made significantly more undertaking magnitude errors when compared to HA. Notably, until research demonstrating ecological validity for the MMAA total and process scores is completed, it is unknown whether performances on the MMAA reflect real-world medication management behaviors.…”

“…The Cyclomeovan medication requires participants to manage the most rules (i.e., take two pills three times a day 2 h before or 1 h after a meal), which may have increased the difficulty of remembering when and whether pills had been indicated as taken during the task. In addition, both HA and individuals with HD demonstrated low rates of errors for BRB on the MMAA, which is consistent with previous findings in individuals with aMCI (Sumida et al, 2018). Given the low difficulty of the BRB pill (i.e., take one pill three times a day), this may suggest that BRB pills do not contribute any sensitivity or specificity to the MMAA; however, additional research with larger and diverse clinical samples will be needed to evaluate this.…”

“…However, analyzing various process errors committed during completion of the MMAA (e.g., medication overtaking and undertaking) may provide insight into the types of difficulties that individuals with HD experience. The present study analyzed self-reported medication management and performance on the MMAA total score as well as MMAA process error scores (see Sumida, Vo, Van Etten, & Schmitter-Edgecombe, 2018) in individuals with HD.…”

Incident Instrumental Activities of Daily Living Difficulty in Older Adults: Which Comes First? Findings From the Advanced Cognitive Training for Independent and Vital Elderly Study

“…Difficulty managing medications is associated with increased hospital admissions, health care costs, and mortality (34). Older adults with memory loss may rate themselves as compliant with medications even when scoring worse on a medication management test compared to healthy peers (35), indicating the early need for assistance with medications. In our study, self-reported incident difficulty with medication management was low but may have been underreported for this reason.…”