Subtle Changes in Medication-taking Are Associated With Incident Mild Cognitive Impairment

Alzheimer Dis Assoc Disord. 2021 Jul-Sep;35(3):237-243. doi: 10.1097/WAD.0000000000000439.


Introduction: Medication-taking is a routine instrumental activity of daily living affected by mild cognitive impairment (MCI) but difficult to measure with clinical tools. This prospective longitudinal study examined in-home medication-taking and transition from normative aging to MCI.

Methods: Daily, weekly, and monthly medication-taking metrics derived from an instrumented pillbox were examined in 64 healthy cognitively intact older adults (Mage=85.5 y) followed for a mean of 2.3 years; 9 transitioned to MCI during study follow-up.

Results: In the time up to and after MCI diagnosis, incident MCI participants opened their pillbox later in the day (by 19 min/mo; β=0.46, P<0.001) and had increased day-to-day variability in the first pillbox opening over time (by 4 min/mo) as compared with stable cognitively intact participants (β=4.0, P=0.003).

Discussion: Individuals who transitioned to MCI opened their pillboxes later in the day and were more variable in their medication-taking habits. These differences increased in the time up to and after diagnosis of MCI. Unobtrusive medication-taking monitoring is an ecologically valid approach for identifying early activity of daily living changes that signal transition to MCI.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Activities of Daily Living*
  • Aged, 80 and over
  • Aging / physiology*
  • Cognitive Dysfunction* / diagnosis
  • Cognitive Dysfunction* / epidemiology
  • Female
  • Follow-Up Studies
  • Humans
  • Longitudinal Studies
  • Male
  • Neuropsychological Tests / statistics & numerical data*
  • Prospective Studies
  • Surveys and Questionnaires
  • Time Factors
  • United States / epidemiology