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Medication adherence in patients with cognitive disorders
Timler W, Hoang MT, Kempa-Timler J, Religa D, Kardas P.. Research Square, 2026-08-20
Topic: Health services, long-term care and technology
Background In aging population, managing multiple chronic diseases often results in polypharmacy and complex treatment regimens, which can challenge medication adherence. Cognitive decline, depression, and low health literacy may further hinder effective pharmacotherapy management. The aim was to assess the relationship between cognitive function, depressive symptoms, self-efficacy, health literacy, and polypharmacy with medication adherence among older adults, and explored patient strategies for managing medications. Methods A cross-sectional study was conducted among 212 primary care patients aged 60 years or older in Łódź, Poland. Standardized tools were used to measure cognition (MMSE), depression (GDS), self-efficacy (GSES), health literacy (HLS-EU-Q16), and adherence (ARMS). Logistic regression models were performed to identify independent predictors of adherence. Results Medication adherence decreased with worsening cognitive performance: 64.4% in patients with normal cognition, 56.1% with mild cognitive impairment, and 38.9% with dementia (p = 0.010). Cognitive status (OR 0.34, 95% CI 0.15–0.78), male gender (OR 3.32, 95% CI 1.52–7.23), living alone (OR 0.48, 95% CI 0.23–0.98), polypharmacy (5–9 drugs daily: OR 0.34, 95% CI 0.16–0.71), and low health literacy (OR 0.37, 95% CI 0.17–0.81) were significantly associated with poorer adherence. Depression, number of specialists caring regularly for the patient, and use of pill organizers were not significantly associated predictors. Conclusions Medication adherence in older adults was strongly influenced by cognitive impairment, gender, health literacy and cohabitation. More research is necessary to determine whether regular cognitive screening in primary care, simplified pharmacotherapy regimens, and individualized adherence support for socially isolated or male patients could improve treatment outcomes in aging populations.
Key findings
- Background In aging population, managing multiple chronic diseases often results in polypharmacy and complex treatment regimens, which can challenge medication adherence.
- Results Medication adherence decreased with worsening cognitive performance: 64.4% in patients with normal cognition, 56.1% with mild cognitive impairment, and 38.9% with dementia (p = 0.010).
- Cognitive status (OR 0.34, 95% CI 0.15–0.78), male gender (OR 3.32, 95% CI 1.52–7.23), living alone (OR 0.48, 95% CI 0.23–0.98), polypharmacy (5–9 drugs daily: OR 0.34, 95% CI 0.16–0.71), and low health literacy (OR 0.37, 95% CI 0.17–0.81) were significantly associated with poorer adherence.
- Depression, number of specialists caring regularly for the patient, and use of pill organizers were not significantly associated predictors.
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Study details
- Study designcross-sectional
- Effect size64.4%; 56.1%; 38.9%
- Evidence strengthLow
How this study scored 16/100
Preprint — not yet peer-reviewed. It scored 31 on the same rubric, but non-peer-reviewed sources are capped at 16, so it shows as 16. Scored zero for sample size, studied in people and randomised / blinded because the record does not state it. We have no data on times cited, citations per year, impact for its field and year, cited by studies here, still being cited, senior author's track record, institution's track record and multi-centre collaboration, so those were left out: it earned 19 of the 62 points we could judge it on, which is 31 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 2 / 10 | Tier 4 — not a peer-reviewed journal (Research Square) |
| Journal's citation record | 0 / 4 | Not a journal article, so the journal's record does not count |
| Study design | 4 / 12 | A snapshot of people at one point in time |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 4 / 10 | Preprint — not yet peer-reviewed. Hosted on a preprint server. |
| How recent | 5 / 5 | 2026 — within 1 year(s) of the newest study here |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 2 / 3 | Effect reported as a number, without an interval or test |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | — / 7 | No citation count (not found in OpenAlex) — left out of this score |
| Citations per year | — / 5 | No citation count or no year — left out of this score |
| Impact for its field and year | — / 6 | No field-weighted citation impact (OpenAlex has none yet) — left out of this score |
| Cited by studies here | — / 6 | Not yet checked against this library's citation graph — left out of this score |
| Still being cited | — / 4 | No yearly citation counts — left out of this score |
| Senior author's track record | — / 4 | Senior author's record not available — left out of this score |
| Institution's track record | — / 3 | No institution listed in OpenAlex — left out of this score |
| Multi-centre collaboration | — / 3 | Institutions not listed — left out of this score |
| Indexed in PubMed | 1 / 2 | Not in PubMed, but has a DOI |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Points | 19 / 62 | Scored on 12 of 20 parts. We have no data for the rest, so they are left out: 19 of the 62 points we could judge it on is 31 out of 100. |
| Total | 31 / 100 | Capped to 16 because this is not a peer-reviewed article. |
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APA 7th
Timler, W., Hoang, M. T., Kempa-Timler, J., Religa, D., & Kardas, P. (2026). Medication adherence in patients with cognitive disorders. Research Square. https://doi.org/10.21203/rs.3.rs-9544605/v1
Vancouver
Timler W, Hoang MT, Kempa-Timler J, Religa D, Kardas P. Medication adherence in patients with cognitive disorders. Research Square. 2026. doi:10.21203/rs.3.rs-9544605/v1.
BibTeX
@article{timler2026-d040d790,
author = {Timler, W. and Hoang, M. T. and Kempa-Timler, J. and Religa, D. and Kardas, P.},
title = {{Medication adherence in patients with cognitive disorders}},
journal = {Research Square},
year = {2026},
doi = {10.21203/rs.3.rs-9544605/v1},
url = {https://doi.org/10.21203/rs.3.rs-9544605/v1}
}