Association between cognitive impairment and antiseizure medication adherence among people with epilepsy in Addis Ababa, Ethiopia
Copyright © 2024 Elsevier Inc. All rights reserved..
BACKGROUND: Cognitive impairment is one of the most common and most troublesome comorbidities among people with epilepsy (PWE). Adherent use of antiseizure medications (ASM) can control seizure episodes in 70% of the cases. However, the relationship between adherent use of ASMs and cognitive impairment in epilepsy is complex.
OBJECTIVE: To assess the association between adherence to ASMs and cognitive status among PWE.
METHODS: We performed a cross-sectional observational study with prospective data collection from PWE using translated and content-validated Amharic versions of the Montreal cognitive assessment tool (MOCA-B) and a four-item Morisky Medication Adherence Scale (Morski-4). Ordinal logistic regression analysis was performed to evaluate the potential risk factors for cognitive impairment, including ASM adherence, physical exercise, and level of education.
RESULTS: A total of 214 individuals with epilepsy were included in this study; 53.7 % were female, and the mean age was 34 years ± 12. The mean age at seizure occurrence was 19 years ± 9. The most common epilepsy type among participants was generalized epilepsy (69 %). The prevalence of poor medication adherence to ASM was 54.2 %. The prevalence of mild cognitive impairment was 65.4 %, and 18.2 % had moderate cognitive impairment, particularly affecting verbal fluency (60.8 %) and memory (43.9 %). Cognitive impairment was significantly associated with poor ASM adherence (AOR = 12.0, 95 %CI, (1.53, 93.75), lower level of physical exercise (AOR = 16.30, 95 %CI (1.24, 214.99), and poor educational attainment with both no formal education (AOR = 0.04, 95 %CI (0.02, 0.14)) and primary or secondary level education (AOR = 0.32, 95 %CI, (0.15, 0.70).
CONCLUSIONS: There is a high rate of cognitive impairment and non-adherence to ASMs in PWE living in Addis Ababa, Ethiopia. Poor ASM adherence is a possible risk factor for cognitive impairment. PWE can benefit from interventions to improve ASM adherence, physical exercise, and better educational attainment.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:152 |
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| Enthalten in: |
Epilepsy & behavior : E&B - 152(2024) vom: 31. März, Seite 109651 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Mamo, Blen [VerfasserIn] |
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| Links: |
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| Themen: |
Adherence |
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| Anmerkungen: |
Date Completed 05.03.2024 Date Revised 05.03.2024 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.yebeh.2024.109651 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| 520 | |a Copyright © 2024 Elsevier Inc. All rights reserved. | ||
| 520 | |a BACKGROUND: Cognitive impairment is one of the most common and most troublesome comorbidities among people with epilepsy (PWE). Adherent use of antiseizure medications (ASM) can control seizure episodes in 70% of the cases. However, the relationship between adherent use of ASMs and cognitive impairment in epilepsy is complex | ||
| 520 | |a OBJECTIVE: To assess the association between adherence to ASMs and cognitive status among PWE | ||
| 520 | |a METHODS: We performed a cross-sectional observational study with prospective data collection from PWE using translated and content-validated Amharic versions of the Montreal cognitive assessment tool (MOCA-B) and a four-item Morisky Medication Adherence Scale (Morski-4). Ordinal logistic regression analysis was performed to evaluate the potential risk factors for cognitive impairment, including ASM adherence, physical exercise, and level of education | ||
| 520 | |a RESULTS: A total of 214 individuals with epilepsy were included in this study; 53.7 % were female, and the mean age was 34 years ± 12. The mean age at seizure occurrence was 19 years ± 9. The most common epilepsy type among participants was generalized epilepsy (69 %). The prevalence of poor medication adherence to ASM was 54.2 %. The prevalence of mild cognitive impairment was 65.4 %, and 18.2 % had moderate cognitive impairment, particularly affecting verbal fluency (60.8 %) and memory (43.9 %). Cognitive impairment was significantly associated with poor ASM adherence (AOR = 12.0, 95 %CI, (1.53, 93.75), lower level of physical exercise (AOR = 16.30, 95 %CI (1.24, 214.99), and poor educational attainment with both no formal education (AOR = 0.04, 95 %CI (0.02, 0.14)) and primary or secondary level education (AOR = 0.32, 95 %CI, (0.15, 0.70) | ||
| 520 | |a CONCLUSIONS: There is a high rate of cognitive impairment and non-adherence to ASMs in PWE living in Addis Ababa, Ethiopia. Poor ASM adherence is a possible risk factor for cognitive impairment. PWE can benefit from interventions to improve ASM adherence, physical exercise, and better educational attainment | ||
| 650 | 4 | |a Observational Study | |
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Adherence | |
| 650 | 4 | |a Antiseizure medications | |
| 650 | 4 | |a Cognitive impairment | |
| 650 | 4 | |a Epilepsy | |
| 650 | 4 | |a Ethiopia | |
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| 700 | 1 | |a Mengesha, Tariku |e verfasserin |4 aut | |
| 700 | 1 | |a Ayele, Biniyam A |e verfasserin |4 aut | |
| 700 | 1 | |a Mamushet Yifru, Yared |e verfasserin |4 aut | |
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