***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Little is known about the cognitive factors associated with adherence to antiestrogen therapy . Our objective was to investigate the association between domain-specific cognitive function and adherence among women in a clinical prevention trial of oral antiestrogen therapies .  We performed a secondary analysis of Co-STAR , an ancillary study of the STAR breast cancer prevention trial in which postmenopausal women at increased breast cancer risk were r and omized to tamoxifen or raloxifene . Co-STAR enrolled nondemented participants ≥65 years old to compare treatment effects on cognition . The cognitive battery assessed global cognitive function ( Modified Mini-Mental State Exam ) , and specific cognitive domains of verbal knowledge , verbal fluency , figural memory , verbal memory , attention and working memory , spatial ability , and fine motor speed . Adherence was defined by a ratio of actual time taking therapy per protocol ≥80 % of expected time . Logistic regression was used to evaluate the association between cognitive test scores and adherence to therapy . The mean age of the 1,331 Co-STAR participants was 67.2 ± 4.3 years . Mean 3MS score was 95.1 ( 4.7 ) and 14 % were nonadherent . In adjusted analyses , the odds of nonadherence were lower for those with better scores on verbal memory [ OR ( 95 % confidence interval ) : 0.75 ( 0.62–0.92 ) ] . Larger relative deficits in verbal memory compared with verbal fluency were also associated with nonadherence [ 1.28 ( 1.08–1.51 ) ] . Among nondemented older women , subtle differences in memory performance were associated with medication adherence . Differential performance across cognitive domains may help identify persons at greater risk for poor adherence . Cancer Prev Res ; 7(1 ) ; 161–8 . © 2013 AACR Background . Patients cite " forgetting " as a reason for nonadherence to highly active antiretroviral therapy ( HAART ) . We measured the effect of a memory-prompting device on adherence to HAART in memory-intact and memory-impaired human immunodeficiency virus (HIV)-infected subjects . Methods . The study was a prospect i ve , r and omized , controlled trial involving 64 HIV-infected adults . The intervention was the Disease Management Assistance System ( DMAS ) device , combined with monthly adherence counseling . Control subjects received only adherence counseling . The DMAS was programmed with HAART regimen data to provide verbal reminders at dosing times .  Adherence was measured for 24 weeks using electronic drug exposure monitor ( eDEM ) caps . Results . A total of 58 subjects completed the 24-week study period ; 28 were HAART naive ( 12 DMAS users and 16 control subjects ) .  Mean adherence scores did not differ significantly between DMAS users ( 80 % ) and control subjects ( 65 % ) . Post hoc analysis of 31 memory-impaired subjects ( 14 DMAS users and 17 control subjects ) revealed significantly higher adherence rates among DMAS users ( 77 % ) , compared with control subjects ( 57 % ) ( P=.001 ) . However , analysis of memory-intact subjects showed that adherence was not significantly improved for DMAS users ( 83 % ) , compared with control subjects ( 77 % ) ( P=.25 ) . At week twelve , 38 % of the DMAS users and 14 % of the control subjects had an undetectable plasma HIV RNA load ( P=.014 ) , and at week 24 , the plasma HIV RNA load was undetectable for 34 % of the DMAS users and 38 % of the control subjects ( P=.49 ) . CD4(+ ) cell counts did not differ between the study arms . Virological and immunological responses were not related to DMAS use in memory-impaired subjects . Conclusion . The DMAS prompting device improved adherence for memory-impaired subjects but not for memory-intact subjects BACKGROUND : Non-adherence in hypertension is a global problem and promoting adherence is necessary to decrease cardiovascular mortality . AIMS : The purpose of this paper is to examine the measurement of adherence to medication taking in hypertensive patients . Adherence was evaluated primarily by means of MEMS ( Medication Event Monitoring System , Aprex Corporation , Fremont , California ) an electronic system that records the date and time of opening of the study medication container . Additional measurements such as change in urinary potassium level , capsule count , client self report and physician estimate of adherence were recorded . METHODS : A r and omised clinical trial was used to assign patients to receive the study medication ( potassium ) or placebo . Descriptive statistics were used to answer the research questions . Frequency and percentage of responses to different measures of adherence were carried out as well as correlation between the measures . RESULTS : One hundred and seven subjects between the ages of 26 and 80 participated in the clinical trial . The results showed that adherence measures varied with lowest adherence from two items of self-report related to forgetfulness ( 46 and 55 % ) and stringent electronic monitoring with the MEMS ( 58 % ) to percentages in the 80–90 range for other self-report items and the general adherence scale . Electronic monitoring correlated best with capsule count at visit 5 . Implication s for health care providers are discussed OBJECTIVE The aim of this study was to prospect ively examine the influence of cognitive , medical , behavioral , and social risk factors on medication nonadherence in community-dwelling older adults with cognitive impairment . METHODS A sample of 339 elderly participants with cognitive impairment , who lived alone and took at least one medication , underwent baseline assessment which included the five subscales of the Dementia Rating Scale ( DRS ) , number of medications , retrospective medication nonadherence , amount of formal and informal assistance , functional impairment , depression , perception of social re sources , comorbidity , and alcohol consumption . The outcome was medication nonadherence during the 12-month prospect i ve period as reported by the participants ' primary care physicians and caregivers at three-month intervals . RESULTS Fifty-nine participants ( 17.4 % ) had , at least , one report of medication nonadherence . Logistic regression analyses indicated for every point increase on the DRS Conceptualization subscale ( OR = 1.14 ; 95 % CI = 1.02 - 1.27 ) , there was a 14 % increase in the odds of nonadherence . For every point increase on the DRS Memory subscale ( OR = 0.89 ; 95 % CI = 0.81 - 0.97 ) and DRS Initiation/Perseveration subscale ( OR = 0.93 ; 95 % CI = 0.87 - 1.00 ) , there was an 11 % decrease and 7 % decrease in the odds , respectively . Having at least one previous occurrence of medication nonadherence ( OR = 2.61 ; 95 % CI = 1.18 - 5.62 ) and taking at least four medications ( OR = 2.58 ; 95 % CI = 1.31 - 5.29 ) , both increased the odds by over 2.5-fold . CONCLUSIONS Our unique finding that better conceptualization predicted nonadherence has important implication s for healthcare providers ' approaches to improve adherence in older adults with cognitive impairment . Replication in future studies is warranted OBJECTIVE Medication nonadherence has been a persistent problem over the past three decades ; forgetting and being distracted from regular routines are the barriers most frequently cited by patients . Prior research on cognitive function and medication adherence has yielded mixed results . DESIGN This report compares findings of three studies : All were longitudinal , two were r and omized controlled intervention trials , and one was descriptive . Sample s of adult patients taking once daily lipid-lowering medication , diabetic patients with comorbid conditions on complex regimens , and early stage breast cancer patients on hormonal therapy  completed similar batteries of st and ardized , valid , neuropsychological tests at baseline . MAIN OUTCOME MEASURES Adherence to medication regimens , over time , was tracked with electronic event monitors . RESULTS Medication nonadherence was prevalent in all studies . Deficits in attention/mental flexibility and /or working memory predicted nonadherence in all studies ; impaired executive function was related to poor adherence in one study . CONCLUSION These findings suggest that better mental efficiency may be the key to better medication adherence with any regimen , and that targeted cognitive functions , which can be easily and quickly assessed , may identify patients at risk of poor adherence regardless of diagnosis or regimen 
    Output:
    
New-learning , memory and executive functioning were associated with improved adherence and formed the focus of most studies .
Multiple factors were identified as modulators of non-adherence .
This review highlights a gap in knowledge on how specific cognitive domains contribute to medication non-adherence amongst CI population s , and demonstrates the current focus is limited to two domains : memory and executive functioning