Assessment of the elderly’s functional ability to manage their medication: a systematic literature review
Objectives: To investigate elderly people’s ability to open medicine containers, and how this ability correlates to some common disorders that may cause functional or cognitive impairment. Methods: Cross-sectional study of older people age 81 years and older, from the second follow-up (1994–1996) of the Kungsholmen project, a population based study of very old people in an urban area of Stockholm, Sweden. Six hundred and four persons (mean age 86.7 years) were tested for their ability to open three types of medicine containers. The disorders studied were rheumatoid arthritis, stroke, Parkinson’s disease, cognitive impairment (measured by mini-mental state examination, MMSE) and impaired vision. Results: We found that 14% were unable to open a screw cap bottle, 32% a bottle with a snap lid, and 10% a blister pack. Female gender, higher age, living in an institution, Parkinson’s disease, rheumatoid arthritis, cognitive impairment and impaired vision were all associated with a decreased ability to open the containers. Less than half of the elderly people who were unable to open one or more of the containers received help with their medication. Among those living in their own homes only 27% received help. Conclusion: Older peoples’ ability to open medicine containers is impaired by several conditions affecting physical and cognitive functioning. Many elderly people who are unable to open medicine containers do not receive help with their medication, particularly those living in their own homes.