title: Difficulty Managing Medications and Finances in Older Adults: A 10-year Cohort Study.
abstract: BACKGROUND
  Difficulty managing medicines and finances becomes increasingly common with advanced age, and compromises the ability to live safely and independently. Remarkably little is known how often this occurs.
  
  
  OBJECTIVE
  To provide population-based estimates of the risk of developing incident difficulty managing medications and finances in older adults.
  
  
  METHODS
  A prospective cohort study.
  
  
  METHODS
  The Health and Retirement Study (HRS), a nationally representative study of older adults.
  
  
  METHODS
  9,434 participants aged 65 and older who did not need help in managing medications or managing finances in 2002. Follow-up assessments occurred every 2 years until 2012.
  
  
  METHODS
  The primary outcomes were time to difficulty managing medications and time to difficulty managing finances. Risk factors such as demographics, comorbidities, functional status, and cognitive status were assessed at baseline. Hazard models that considered the competing risk of death were used to estimate both the cumulative incidence of developing difficulty managing medications and finances and to identify potential risk factors. Analyses were adjusted for age, gender, race, marital status, wealth and education.
  
  
  RESULTS
  The 10 years incidence of difficulty increased markedly with age, ranging from 10.3% (95% CI 9.3-11.6) for managing medications and 23.1% (95% CI 21.6-24.7) for managing finances in those aged 65-69, to 38.2% (95% CI 33.4-43.5) for medicines and 69% (95% CI 63.7-74.3) for finances in those over age 85. Women had a higher probability of developing difficulty managing medications and managing finances than men.
  
  
  CONCLUSIONS
  This study highlights the importance of preparing older adults for the likelihood they will need assistance with managing their medicines and finances as the risk for having difficulty with these activities over time is substantial.
authors.affiliation: Julius Center for Health Sciences and Primary Care, University Medical Center, Utrecht, the Netherlands.|Department of General Practice Nursing Science, and University of Applied Sciences, Utrecht, the Netherlands.|University of Applied Sciences Utrecht, the Netherlands, School of Nursing, Research group Care for Older People, San Francisco, California.
authors.forename: Nienke
authors.initials: N
authors.lastname: Bleijenberg
authors.affiliation: Division of Geriatrics, University of California, San Francisco, California.|Veterans Affairs Medical Center, San Francisco, California.
authors.forename: Alexander K
authors.initials: AK
authors.lastname: Smith
authors.affiliation: Division of Geriatrics, University of California, San Francisco, California.|Veterans Affairs Medical Center, San Francisco, California.
authors.forename: Sei J
authors.initials: SJ
authors.lastname: Lee
authors.affiliation: Division of Geriatrics, University of California, San Francisco, California.|Veterans Affairs Medical Center, San Francisco, California.
authors.forename: Irena Stijacic
authors.initials: IS
authors.lastname: Cenzer
authors.affiliation: Division of Geriatrics, University of California, San Francisco, California.|Veterans Affairs Medical Center, San Francisco, California.
authors.forename: John W
authors.initials: JW
authors.lastname: Boscardin
authors.affiliation: Division of Geriatrics, University of California, San Francisco, California.|Veterans Affairs Medical Center, San Francisco, California.
authors.forename: Kenneth E
authors.initials: KE
authors.lastname: Covinsky
mesh_terms: D000203:Activities of Daily Living / Q000523:psychology*; D000368:Aged; D015897:Comorbidity; D005260:Female; D006801:Humans; D057187:Independent Living; D008137:Longitudinal Studies; D008297:Male; D055118:Medication Adherence / Q000523:psychology; D011446:Prospective Studies; D012307:Risk Factors; D012737:Sex Factors; D016903:Drug Monitoring
keywords: community-dwelling older people; finances; incidence difficulty; medications; risk factors