Depression, cognitive impairment, and understanding of medication directions in hospitalized elderly patients

Purpose. The objectives of this study were 1) to assess understanding of medication directions of drug therapy in a group of hospitalized elderly who were not receiving assistance with medication administration; and 2) to determine whether depression, cognitive impairment, age, and other characteristics are associated with patient understanding of medication directions. Methods. The sample consisted of 117 hospitalized elderly patients aged 70 years and older who were taking two or more medications prior to hospitalization and reported medication self-administration. Data collection included demographic characteristics, mood, cognition, and pre-admission medication use and knowledge. Results. Thirteen (11%) patients did not understand directions for two or more pre-admission medications. Being 80 years or older was associated with not understanding medication directions (OR = 6.2, p = .017). There was a trend for depressive symptoms to be associated with not understanding medication directions, however, this was not significant (OR = 3.9, p = .058). Conclusions. Although all individuals should be assessed for comprehension of their medication regimens, those over 80 years of age with depressive symptoms deserve increased attention. Alternative strategies may need to be developed to improve medication knowledge in the older, depressed hospitalized patient.