Polypharmacy and Cognition Function among Rural Adults

Rafia S. Rasu, Nistha Shrestha, Aliza R. Karpes Matusevich, Rana Zalmai, Stephanie Large, Leigh Johnson, Sid E. O'Bryant, Erin Abner

Research output: Contribution to journalArticlepeer-review

4 Scopus citations


Background: Polypharmacy (using≥5 medications) is associated with poor health outcomes. Mixed results from past studies surrounding chronic medication use, control of chronic conditions, and their effects on cognitive performance warrant further attention. Objective: Investigate a link between polypharmacy and cognition function in rural-dwelling adults in Texas, USA. Methods: Project FRONTIER (Facing Rural Obstacles to Healthcare Now Through Intervention, Education Research) is a cross-sectional epidemiological study using community-based participatory research in three counties of Texas. Residents age > 40 were eligible for inclusion. The primary outcome is cognitive impairment, and exposures of interest are polypharmacy; comorbidities; and diabetes, hypertension, and depression medication. Logistic regression was used to assess association. Results: Six hundred eighty-nine individuals participated; the mean age was 61, and the majority were female (68.7%).The median number of medications taken by participants was 3.3 (IQR: 0-5); the rate of polypharmacy was 29.6%. Anti-hypertensive agents were the most common medications (15%) used. Polypharmacy users were 2.84 times more likely to have cognitive impairment [OR: 2.84, 95%CI (1.32-6.09)] than those using < 5 medications. Participants on hypertensive medications had 1.85 times higher odds [OR: 1.85, 95%CI (1.14-3.01)] of having cognitive impairment than those who did not have cognitive impairment. Conclusion: Polypharmacy increases the odds of cognitive impairment. The odds of presenting with cognitive impairment increased as the number of medications increased. Additionally, we identified a large, concerning number of participants with pharmacotherapy and poor chronic disease management. A larger study should examine medication adherence among rural elders to manage chronic disease and any healthcare barriers to adherence.

Original languageEnglish
Pages (from-to)607-619
Number of pages13
JournalJournal of Alzheimer's Disease
Issue number2
StatePublished - 2021

Bibliographical note

Publisher Copyright:
© 2021 - IOS Press. All rights reserved.


  • Antidepressants
  • Antidiabetics
  • Antihypertensive
  • Cognition performance
  • Cognitive impairment
  • Dementia
  • Medications
  • Polypharmacy

ASJC Scopus subject areas

  • Neuroscience (all)
  • Clinical Psychology
  • Geriatrics and Gerontology
  • Psychiatry and Mental health


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