Cognitive Impairment Is Independently Associated with Non-Adherence to Antithrombotic Therapy in Older Patients with Atrial Fibrillation

Atrial Fibrillation (AF) patients could reduce their risk of stroke by using oral antithrombotic therapy. However, many older people with AF experience cognitive impairment and have limited health literacy, which can lead to non-adherence to antithrombotic treatment. This study aimed to investigate...

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Bibliographic Details
Published in:International journal of environmental research and public health 2019-07, Vol.16 (15), p.2698
Main Authors: Seong, Hyun-Joo, Lee, Kyounghoon, Kim, Bo-Hwan, Son, Youn-Jung
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Anticoagulants
Atrial Fibrillation - complications
Cognitive ability
Cognitive Dysfunction - complications
Cross-Sectional Studies
Female
Fibrillation
Fibrinolytic Agents - administration & dosage
Fibrinolytic Agents - pharmacology
Health literacy
Health risks
Health services
Humans
Impairment
Male
Medication Adherence - psychology
Middle Aged
Mortality
Odds Ratio
Older people
Patient compliance
Population studies
Prevention
Public health
Risk Factors
Stroke
Stroke - etiology
Stroke - prevention & control
Studies
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Summary:Atrial Fibrillation (AF) patients could reduce their risk of stroke by using oral antithrombotic therapy. However, many older people with AF experience cognitive impairment and have limited health literacy, which can lead to non-adherence to antithrombotic treatment. This study aimed to investigate the influence of cognitive impairment and health literacy on non-adherence to antithrombotic therapy. The study performed a secondary analysis of baseline data from a cross-sectional survey of AF patients' self-care behaviors at a tertiary university hospital in 2018. Data were collected from a total of 277 AF patients aged 65 years and older, through self-reported questionnaires administered by face-to-face interviews. Approximately 50.2% of patients were non-adherent to antithrombotic therapy. Multiple logistic regression analysis revealed that cognitive impairment independently increased the risk of non-adherence to antithrombotic therapy (odds ratio = 2.628, 95% confidence interval = 1.424-4.848) after adjustment for confounding factors. However, health literacy was not associated with non-adherence to antithrombotic therapy. Cognitive impairment is a significant risk factor for poor adherence to antithrombotic therapy. Thus, health professionals should periodically assess both cognitive function after AF diagnosis and adherence to medication in older patients. Further studies are needed to identify the factors that affect cognitive decline and non-adherence among AF patients.
ISSN:1660-4601
1661-7827
1660-4601
DOI:10.3390/ijerph16152698