Background Medication adherence is an integral part of the comprehensive care of patients with atrial fibrillation （AF） receiving oral anticoagulations （OACs） therapy. Many patients with AF are elderly and may suf...Background Medication adherence is an integral part of the comprehensive care of patients with atrial fibrillation （AF） receiving oral anticoagulations （OACs） therapy. Many patients with AF are elderly and may suffer from some form of cognitive impairment. This study was conducted to investigate whether cognitive impairment affects the level of adherence to anticoagulation treatment in AF patients. Me- thods The study involved 111 AF patients （mean age, 73.5±8.3 years） treated with OACs. Cognitive function was assessed using the Mini Mental State Examination （MMSE）. The level of adherence was assessed by the 8-item Mot^sky Medication Adherence Scale （MMAS-8）. Scores on the MMAS-8 range from 0 to 8, with scores 〈 6 reflecting low adherence, 6 to 〈 8 medium adherence, and 8 high adherence. Re- sults 46.9% of AF patients had low adherence, 18.8% had moderate adherence, and 33.3% had high adherence to OACs. Patients with lower adherence were older than those with moderate or high adherence （76.6 ±8.7 vs. 71.3 ~ 6.4 vs. 71.1 ± 6.7 years） and obtained low MMSE scores, indicating cognitive disorders or dementia （MMSE = 22.3 ± 4.2）. Patients with moderate or high adherence obtained high MMSE test results （27.5 ±1.7 and 27,5 ± 3.6）. According to Spearman＇s rank correlation, worse adherence to treatment with OACs was determined by older age （rs = -0.372） and lower MMSE scores （rs = 0.717）. According to multivariate regression analysis, the level of cognitive function was a significant independent predictor of adherence （b = 1.139）. Conclusions Cognitive impairment is an independent determinant of compliance with pharmacological therapy in elderly patients with AF. Lower adherence, beyond the assessment of cognitive function, is related to the age of patients.展开更多
Recent studies have suggested that patients with high CHA2DS2VASc-score [Congestive Heart failure, hyperten- sion, Age ≥ 75 years （doubled）, Diabetes, Stroke （doubled）, Vascular disease, Age 65-74 years, Sex cate...Recent studies have suggested that patients with high CHA2DS2VASc-score [Congestive Heart failure, hyperten- sion, Age ≥ 75 years （doubled）, Diabetes, Stroke （doubled）, Vascular disease, Age 65-74 years, Sex category （female sex）] thromboembolic complications occurred irrespective of the presence of atrial fibrillation （AF） and anticoagulant therapy may be initiated irrespective of documented AF.展开更多
Thromboembolic complications represent a substantial problem in patients with atrial fibrillation （AF）. The prevalence of AF burden and associated arterial and venous thrombosis progressively increases with age. At ...Thromboembolic complications represent a substantial problem in patients with atrial fibrillation （AF）. The prevalence of AF burden and associated arterial and venous thrombosis progressively increases with age. At the same time, representative national data regarding stroke incidence in AF patients aged 80 and older are limited.展开更多
文摘Background Medication adherence is an integral part of the comprehensive care of patients with atrial fibrillation （AF） receiving oral anticoagulations （OACs） therapy. Many patients with AF are elderly and may suffer from some form of cognitive impairment. This study was conducted to investigate whether cognitive impairment affects the level of adherence to anticoagulation treatment in AF patients. Me- thods The study involved 111 AF patients （mean age, 73.5±8.3 years） treated with OACs. Cognitive function was assessed using the Mini Mental State Examination （MMSE）. The level of adherence was assessed by the 8-item Mot^sky Medication Adherence Scale （MMAS-8）. Scores on the MMAS-8 range from 0 to 8, with scores 〈 6 reflecting low adherence, 6 to 〈 8 medium adherence, and 8 high adherence. Re- sults 46.9% of AF patients had low adherence, 18.8% had moderate adherence, and 33.3% had high adherence to OACs. Patients with lower adherence were older than those with moderate or high adherence （76.6 ±8.7 vs. 71.3 ~ 6.4 vs. 71.1 ± 6.7 years） and obtained low MMSE scores, indicating cognitive disorders or dementia （MMSE = 22.3 ± 4.2）. Patients with moderate or high adherence obtained high MMSE test results （27.5 ±1.7 and 27,5 ± 3.6）. According to Spearman＇s rank correlation, worse adherence to treatment with OACs was determined by older age （rs = -0.372） and lower MMSE scores （rs = 0.717）. According to multivariate regression analysis, the level of cognitive function was a significant independent predictor of adherence （b = 1.139）. Conclusions Cognitive impairment is an independent determinant of compliance with pharmacological therapy in elderly patients with AF. Lower adherence, beyond the assessment of cognitive function, is related to the age of patients.
文摘Recent studies have suggested that patients with high CHA2DS2VASc-score [Congestive Heart failure, hyperten- sion, Age ≥ 75 years （doubled）, Diabetes, Stroke （doubled）, Vascular disease, Age 65-74 years, Sex category （female sex）] thromboembolic complications occurred irrespective of the presence of atrial fibrillation （AF） and anticoagulant therapy may be initiated irrespective of documented AF.
文摘Thromboembolic complications represent a substantial problem in patients with atrial fibrillation （AF）. The prevalence of AF burden and associated arterial and venous thrombosis progressively increases with age. At the same time, representative national data regarding stroke incidence in AF patients aged 80 and older are limited.
