Discordant Medication Beliefs in Black Individuals With Mild Cognitive Impairment and Diabetes

Abstract

Objective: To investigate the effects of discordant medication beliefs on diabetes self-management and glycemic control in older Black individuals with diabetes and Mild Cognitive Impairment (MCI).

Methods: Cross-sectional analysis of baseline data from two clinical trials testing behavioral interventions to improve glycemic control in older Black primary care patients with diabetes and MCI.

Results: The mean number of discordant medication beliefs was 6 (SD = 3; range 0 to 16). Sixty-seven of 246 (27%) participants held ≥ 9 discordant beliefs (i.e., one SD above the mean), and these participants had worse diabetes self-management and glycemic control than participants with fewer beliefs.

Conclusions: Discordant medication beliefs, low adherence to diabetes self-management, poor glycemic control, and impaired cognition may exist in a causal relationship. Modifying discordant medication beliefs may eliminate the first step of this pathogenic sequence and reduce risk of cognitive decline in a high-risk population of older Black individuals with diabetes.

Keywords: Black individuals; Diabetes; Glycemic control; Mild Cognitive Impairment.