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Medication management and treatment adherence in Parkinson's disease patients with mild cognitive impairment

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Abstract

Introduction

The key feature that distinguishes mild cognitive impairment (MCI) from dementia is the absence of significant functional decline because of cognitive impairment. In Parkinson's disease patients (PD) with MCI (PD-MCI), the effect of cognitive impairment on complex instrumental daily activities, such as medication management, is not well established.

Method

26 patients with PD-MCI (diagnosed to Level 2 Movement Disorders Society diagnostic criteria) and 32 idiopathic PD patients without cognitive impairment participated in the study. A detailed neuropsychological testing battery (including tests for attention and working memory, executive functions, language, visuospatial functions, episodic memory) and various prospective memory tasks were applied to the patients. Medication taking behaviors were evaluated using two different methods based on the performance (medication management ability assessment) and self-reporting (adherence scale).

Results

The PD-MCI group obtained significantly lower scores in medication management assessment and made more mistakes on following prescription instructions (e.g., they took more or less tablets and did not use medications as instructed with regard to meal times). Cognitive areas predicting success in medication management performance were language, event-based prospective memory and visuospatial functions. There was no significant difference between the two groups’ self-reporting of adherence.

Conclusion

Mild cognitive impairment in patients with PD adversely affects medication management. Diagnosing MCI in PD is important to ensure that the appropriate measures can be taken to provide support and improve the medication management process. Adherence assessments based on self-reporting may not provide reliable and sensitive information in patients with PD-MCI.

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Data availability

The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions.

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Acknowledgements

The authors wish to acknowledge the for contribution of Omer Uysal in the statistical analysis and Sukriye Akca Kalem (Clinical Neuropsychologist) for her assistance with neuropsychological assessment.

Funding

This research was supported by TUBITAK (The Scientific and Technological Research Council of Turkey) Research Fellowship Program for PhD Students [2211-A].

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Authors and Affiliations

  1. Department of Neuroscience, Aziz Sancar Institute of Experimental Medicine, Istanbul University, Istanbul, Turkey

    Betul Sumbul-Sekerci

  2. Department of Clinical Pharmacy, Faculty of Pharmacy, Bezmialem Vakıf University, Istanbul, Turkey

    Betul Sumbul-Sekerci

  3. Behavioral Neurology and Movement Disorders Unit, Department of Neurology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey

    Hasmet A. Hanagasi, Basar Bilgic, Zeynep Tufekcioglu, Hakan Gurvit & Murat Emre

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  1. Betul Sumbul-Sekerci
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  2. Hasmet A. Hanagasi
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  3. Basar Bilgic
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  4. Zeynep Tufekcioglu
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  5. Hakan Gurvit
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  6. Murat Emre
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Correspondence to Betul Sumbul-Sekerci.

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Ethis approval was obtained from the Ethics Committee of Istanbul Faculty of Medicine, Istanbul University (22.12.2017/21).

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Sumbul-Sekerci, B., Hanagasi, H.A., Bilgic, B. et al. Medication management and treatment adherence in Parkinson's disease patients with mild cognitive impairment. Acta Neurol Belg 123, 823–829 (2023). https://doi.org/10.1007/s13760-022-01916-1

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  • DOI: https://doi.org/10.1007/s13760-022-01916-1

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