The Difficulty of Opening Medicine Containers in Old Age: A Population-Based Study
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.
KeywordsCognitive impairment Drug utilization Elderly Medication management Medicine containers Sweden
Österlind, PO, Bucht, G 1991Drug consumption during the last decade among persons born in 1902 in Umea, Sweden: a longitudinal population studyDrugs Aging147786PubMedGoogle Scholar
Chrischilles, EA, Foley, DJ, Wallace, RB, Lemke, JH, Semla, TP, Hanlon, JT, et al. 1992Use of medications by persons 65 and over: data from the established populations for epidemiologic studies of the elderlyJ Gerontol47M13744PubMedGoogle Scholar
Sherman, FT, Warach, JD, Libow, LS 1979Child-resistant containers for the elderlyJ Am Med Assoc24110012CrossRefGoogle Scholar
Darnell, JC, Murray, MD, Martz, BL, Weinberger, M 1986Medication use by ambulatory elderly. An in-home surveyJ Am Geriatr Soc3414PubMedGoogle Scholar
Jahnigen, DW 1988Problems with pill packagingJ Am Geriatr Soc3627980PubMedGoogle Scholar
Keram, S, Williams, ME 1988Quanitfying the ease or difficulty older persons experience in opening medication containersJ Am Geriatr Soc36198201PubMedGoogle Scholar
Robbins, LJ, Jahnigen, DW 1984Child-resistant packaging and the geriatric patientJ Am Geriatr Soc324502PubMedGoogle Scholar
Atkin, PA, Finnegan, TP, Ogle, SJ, Shenfield, GM 1994Functional ability of patients to manage medication packaging: a survey of geriatric inpatientsAge Ageing231136PubMedGoogle Scholar
Edelberg, HK, Shallenberger, E, Wei, JY 1999Medication management capacity in highly functioning community-living older adults: detection of early deficitsJ Am Geriatr Soc475926PubMedGoogle Scholar
Nikolaus, T, Kruse, W, Bach, M, Specht-Leible, N, Oster, P, Schlierf, G 1996Elderly patients’ problems with medication. An in-hospital and follow-up studyEur J Clin Pharmacol492559CrossRefPubMedGoogle Scholar
Ruscin, JM, Semla, TP 1996Assessment of medication management skills in older outpatientsAnn Pharmacother3010838PubMedGoogle Scholar
Agnholt, J, Bendixen, K, Fossgreen, J 1983Medicinemballageoplukning af patienter med reumatoid arthritisUgeskr Laeger14522169PubMedGoogle Scholar
Glerup, E, Dengsö, H 1990Åbning of medicinemballageUgeskr Laeger152204750PubMedGoogle Scholar
Lisberg, RB, Higham, C, Jayson, MIV 1983Problems for rheumatic patients in opening dispensed drug containersBr J Rheumatol22145958Google Scholar
Verheggen-Laming, BNE, Phiferons, H, Mulder, EFM, Meij, NT, Harten, RPW, Dijkmans, BAC 1988Comparison of packages for suppositories by patients with reumatoid arthritisScand J Rheumatol171615PubMedGoogle Scholar
Fratiglioni, L, Grut, M, Forsell, Y, Viitanen, M, Grafström, M, Holmen, K, et al. 1991Prevalence of Alzheimer’s disease and other dementias in an elderly urban population: relationship with age, sex and educationNeurology41188692PubMedGoogle Scholar
Fratiglioni, L, Viitanen, M, Bäckman, L, Sandman, P-O, Winblad, B 1992Occurrence of dementia in advanced age: the study design of the Kungsholmen projectNeuroepidemiology112936PubMedGoogle Scholar
Fratiglioni, L, Viitanen, M, Strauss, E, Tontodonati, V, Herlitz, A, Winblad, B 1997Very old women at highest risk of dementia and Alzheimer’s disease: incidence data from the Kungsholmen Project, StockholmNeurology481328PubMedGoogle Scholar
Folstein, MF, Folstein, SE, McHugh, PR 1975’Mini-Mental State’: A practical method for grading the cognitive state of patients for the clinicianJ Psychiatr Res1218998CrossRefPubMedGoogle Scholar
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 3rd ed., revised (DSM III-R). Washington, DC 1987.Google Scholar