The following is a summary of “Impact of depressive symptoms on medication adherence in older adults with chronic neurological diseases,” published in the February 2024 issue of Psychiatry by Schönenberg et al.
Nonadherence to medication significantly worsens health outcomes, particularly among older adults with chronic illness facing complex medication regimens due to multimorbidity; while depressive symptoms are recognized as a key contributor to nonadherence, the precise underlying mechanisms remain unclear.
Researchers conducted a retrospective study to address the limitation of sum scores in capturing the intricate nature of depressive symptoms by advocating for evaluating individual symptoms to understand their impact better.
They adopted a symptom-based methodology, conducting correlation, network, and regression analyses utilizing depressive symptoms delineated by items from the revised Beck Depression Inventory II (BDI) to investigate their association with nonadherence among a cohort of 731 older adults diagnosed with chronic neurological diseases. Nonadherence was evaluated using the self-reported Stendal Adherence to Medication Score (SAMS).
The results showed that even after accounting for sociodemographic and health-related factors, the BDI emerged as the primary predictor of non-adherence. Loss of Interest and Difficulty with Concentration were consistently highlighted as significant contributors to nonadherence across various analytical methods. Loss of Interest was associated with other affective BDI items, and Difficulty with Concentration was linked to somatic symptoms. Fatigue, Problems with Decision Making, Suicidal Thoughts, and Feelings of Worthlessness were also identified as factors contributing to nonadherence.
Investigators concluded that rather than just a lack of motivation or belief in medication, depressive symptoms like worthlessness, suicidal ideation, and fatigue lead to a general apathy towards health improvement, hindering medication adherence in elderly patients with neurological conditions. Tailored interventions targeting these specific symptoms are crucial for better health outcomes and adherence.
Source: bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-024-05585-7