Prevalence and Outcomes of Potentially Inappropriate Medications in Elderly Patients with Mild Cognitive Impairment

Abstract

Background: The world is experiencing growth in the number and proportion of older persons in the population. With multi morbidity increasing among older people, use of potentially inappropriate medications (PIMs), especially anticholinergic drug, in elderly patients with mild cognitive impairment can become an adverse effect in long term.
Methods: Cross-sectional analytic study, 170 elderly outpatients with mild cognitive impairment, screening by MoCA and TMSE, comprise 56 patients with PIMs and 114 patients without PIMs. Cognitive, neuropsychological and physical function test were performed. Using percentage, mean, median, Fisher’s exact test, independent t-test, Mann-Whitney u test, bivariate analysis, multivariate logistic regression to analyze.
Results: Prevalence of PIMs in elderly patients with mild cognitive impairment was 32.9 % (95% CI 25.8 – 40.1). Number of patients in PIMs group after applying the MoCA tool less than 20 was statistical significance compared with non-PIMs group (p = 0.008). In multivariate model shown the risk of patients in PIMs group had increased adjusted odd ratio (AOR) 2.02-fold compared with non-PIMs group (aOR= 2.02 (95% CI 0.95 – 4.30)), although results did not achieve statistical significance.
Conclusion: Elderly patients with mild cognitive impairment, the use of PIMs associated MoCA less than non-PIMs group statistical significance. Long term use of PIMs lead to an adverse event, early intervention still possible before their cognitive performance declined and progresses to dementia and overall compromised health condition.