Back to Journals » Clinical Interventions in Aging » Volume 13

Relation between cognitive impairment and treatment adherence in elderly hypertensive patients

Authors Chudiak A, Uchmanowicz I, Mazur G

Received 16 January 2018

Accepted for publication 1 May 2018

Published 6 August 2018 Volume 2018:13 Pages 1409—1418


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 4

Editor who approved publication: Dr Richard Walker

Anna Chudiak,1 Izabella Uchmanowicz,1 Grzegorz Mazur2

1Department of Clinical Nursing, Faculty of Health Sciences, Wroclaw Medical University, Wrocław, Poland; 2Department and Clinic of Internal and Occupational Diseases and Hypertension, Wroclaw Medical University, Wrocław, Poland

Background: Nonadherence to medical treatment and lack of cooperation in hypertensive patients >65 years of age are believed to be caused by a number of age-related problems, such as cognitive impairment. Numerous epidemiological and prospective studies have demonstrated that hypertension that remains untreated for many years or is unsuccessfully treated for reasons such as poor compliance and adherence of the patient may lead to cognitive impairment.
Objective: The objective of this study was to investigate the occurrence of cognitive impairment and its effect on treatment compliance and adherence in elderly hypertensive patients.
Design: This study was an analytical cross-sectional study.
Patients and methods: The study was conducted on 300 patients aged 65–91 years (mean age=71.8 years, SD=7.8 years) diagnosed with hypertension. The following research tools were used: 1) Hill-Bone High Blood Pressure Compliance Scale (HBCS) and 2) Mini–Mental State Examination (MMSE). We also analyzed medical documentation to obtain basic sociodemographic and clinical data. The study was approved by the Bioethics Committee of the Medical University of Wroclaw (no KB-144/2016).
Results: Cognitive impairment occurred in 60% of the patients. A group of 63% patients complied with antihypertensive therapy, with the mean score of 20.8 points. Cognitive impairment was strongly correlated with the total score of the HBCS questionnaire (p<0.001) and two of its subscales: “appointment keeping” (p<0.001) and “medication taking” (p<0.001).
Conclusion: Compliance and adherence levels are higher in patients with a higher educational level, whereas male sex adversely affects treatment adherence in elderly hypertensive patients.

Keywords: cognitive impairment, compliance, hypertension, old age, treatment adherence

Creative Commons License This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.

Download Article [PDF]  View Full Text [HTML][Machine readable]