One-year follow-up of medication management capacity in highly functioningolder adults

Background, We tested the hypothesis that impairment in the ability to take medication independently predicts early functional decline. Methods. A 12-month, prospective cohort study was performed at two continui ng-care retirement facilities using the Drug Regimen Unassisted Grading Sca le (DRUGS). This geriatric screening tool utilizes a stepwise progression o f four tasks: (i) identification, (ii) access, (iii) dosage, and (iv) timin g. Results, Forty-seven (86%) of the eligible participants completed the 12-mo nth follow-up assessment; three were transferred to skilled nursing facilit ies. The mean age at study entry was 84.2 i: 5.1 years; 72% of the particip ants were women, and 68% were college educated. At 12 months there was a de cline in the Mini-Mental State Examination (MMSE) score(p = .029), an incre ase in the timed "Up and Go" test(p = .023), and a decline in the DRUGS sco re (p = .029). Nine (18%) of the participants resided in assisted- versus i ndependent-living situations compared with three par participants (5%) at s tudy entry (p = .031). Both 12-month DRUGS score and 12-month self-reported medication manage ment capacity were associated with 12-month MMSE (p = .0 001 and p = .019, respectively). Baseline DRUGS score was associated with 1 2-month MMSE and Geriatric Depression Scale scores (p = .0002 and p = .002, respectively). Both baseline DRUGS score and self-reported medication mana gement capacity were also associated with residence in assisted-living comm unities at 6 months (p = .029 and p = .040, respectively). MMSE was not ass ociated with any of the clinical outcomes. Conclusions. The DRUGS tool may predict functional decline in highly functi oning older adults.