Date Presented 04/01/2022
Complex instrumental activities of daily living (IADLs) are significantly affected with moderate to severe cognitive impairment. Many health care professionals have assumed that with mild cognitive impairment (MCI) or in the prediagnosis stages of disease. IADLs such as medication management are not significantly affected. This scoping review showed a strong correlation between MCI and medication errors, indicating the importance of assessing MCI and medication management before the recognition of cognitive deficits or diagnosis.
Primary Author and Speaker: Denise Allen
Contributing Authors: Lynn Jaffe, Allison Pfleghaar
Medication management is an important IADL with significant consequences when it cannot be completed correctly due to unintentional errors. With the inclusion of medication management in the occupational therapy scope of practice, it is important for therapists to understand its correlation to mild cognitive impairment to better recognize and address areas of need for clients.
METHOD: A scoping review was conducted to answer two questions: (1) What is the association of mild cognitive impairment with medication management? (2) Which areas of cognitive processes might foreshadow unintentional medication errors? An extensive search of nine databases and full article review of 122 articles yielded 18 articles after inclusion/exclusion criteria were applied.
RESULTS: Mild cognitive impairment was the focus of eight articles, executive function was reviewed in nine articles, and memory was discussed in four articles, with some overlap of concepts occurring in several articles. Mild cognitive impairment (MCI) showed a strong correlation with medication management errors. Executive function showed a correlation to medication management in the majority of studies with mixed relationships with different subcategories of executive function. Memory showed mixed results, but tended to have a correlation with medication management.
CONCLUSION: It is important for occupational therapists to assess MCI in older adults as it may go unrecognized in earlier stages. Assessing MCI can help identify if further assessment of medication management tasks is needed. When considering types of assessments, choosing ones that have components of executive function and memory may be beneficial.
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