Barriers to Medication Adherence and Mild Cognitive Impairment Among African Americans with Persistently Uncontrolled Hypertension: A Cross-sectional Analysis from the Southeastern Collaboration Trial.

Singh, Sunidhi; Ringel, Joanna Bryan; Baquero, Elizabeth; Cummings, Doyle M; Halladay, Jacqueline; Cherrington, Andrea L; Andreae, Lynn; Safford, Monika · J Gen Intern Med · 2026

cross_sectional · Level IV

Where this comes from

Abstract

Mild cognitive impairment (MCI) is frequently undetected and may lead to medication nonadherence. We examined whether more reported barriers to medication adherence could signal the presence of MCI. We developed a count of barriers (0, 1, 2, and ≥3) and determined the independent association between a greater number of barriers and odds of MCI. Rural primary care practices in Alabama and North Carolina. One thousand two hundred seventy-nine participants of the Southeastern Collaboration to Improve Blood Pressure Control trial; all were African Americans with persistently uncontrolled hypertension. Presence of mild cognitive impairment (MCI). Participants reporting ≥ 2 barriers had 2.40 (95% CI 1.03-5.75) times higher adjusted odds of MCI compared to those reporting none; those reporting ≥ 3 barriers had 3.80 (95% CI 1.74-8.31) higher odds. As the number of barriers increased, odds of MCI increased (p for trend < 0.001). Barriers to medication adherence may signal MCI.