Mild cognitive impairment (MCI) was characterized by mild impairment in one or more cognitive functions and was associated with an increased risk of failure to take prescribed medications. Hypertension was prevalent among persons with MCI (PwMCI), and nonadherence to medications increased the risk of accelerated cognitive decline through cerebrovascular disease. Adherence was often only 46% or lower among PwMCI. Further, the COVID-19 pandemic resulted in the isolation of these individuals from care partners (friends, family, and healthcare workers) who assisted with medication management, uncovering the urgent need for developing self-management tools.

A theory-based mobile health (mHealth) system called Medication Education, Decision Support, Reminding, and Monitoring (MEDSReM) had been previously developed to support adherence in cognitively normal older adults, and it could be adapted for PwMCI. No existing studies had evaluated the benefits of mHealth self-management tools to support hypertension medication adherence for PwMCI. In order for such digital interventions to be beneficial, they needed to be carefully designed and adapted to meet the unique capabilities and limitations of PwMCI. User-centered technology had been shown to promote independence and autonomy by compensating for lost cognitive skills.

In this project, the team was poised to address the unique needs for digital technology use in this at-risk population of PwMCI based on user-centered design to guide the development of the Medication Education, Decision Support, Reminding, and Monitoring-Memory (MEDSReM-M) system, conduct iterative usability testing to optimize the system for PwMCI, and examine its efficacy in supporting hypertension medication adherence.