The effect of cognitive decline on the medication adherence in patients with type II diabetes mellitus

Abstract

Background: Type II Diabetes Mellitus (T2DM) is a risk factor for decreased cognitive function that is rarely recognised by patients, apart from age and other factors. Objective: This study aims to assess the effect of decreased cognitive function on medication adherence in T2DM patients. Method: This study used a cross-sectional design conducted at the Pasar Minggu Community Health Center, Jakarta, Indonesia. Cognitive function was assessed using the validated Indonesian version of the Montreal Cognitive Assessment (MoCA-Ina) questionnaire. Results: One hundred twenty-seven T2DM patients (75.6% female) with a mean age of 58.69 years were recruited. The proportion of T2DM patients with decreased cognitive function was quite high, namely 61%. The proportion of non-adherent patients in the group with decreased cognitive function (70.6%) was greater than in the normal group (29.4%). Decreased cognitive function significantly affected non-adherence in taking medication with aOR 3.744 (95% CI 1.485–9.442), p = 0.005, after controlling for age, education level, HbA1c value, and comorbid dyslipidemia. Conclusion: Patients with decreased cognitive function are 3.7 times more likely to be non-compliant with medication, regardless of age, education level, HbA1c value, and dyslipidemia. Special management is needed for T2DM patients with decreased cognitive function, such as caregiver assistance, education by pharmacists, and simpler drug regimes.