Cognitive dysfunction and poor health literacy are common in veterans presenting with acute coronary syndrome: insights from the MEDICATION study

Figures & data

Table 1 SLUMS score and covariates

	Dementia	MNCD	Normal	All	P-value
N subjects	37	130	83	250
Age	66.54 (9.36)	64.23 (9.28)	61.7 (8.3)	63.8 (9.07)	0.02
Sex – number male	36 (97.3)	128 (98.5)	80 (96.4)	244 (97.6)	0.62
Race – number white	23 (62.2)	102 (78.5)	69 (83.1)	194 (77.6)	0.04
Smoking history	13 (36.1)	42 (32.6)	22 (26.5)	77 (31)	0.50
Hypertension	33 (91.7)	115 (88.5)	79 (95.2)	227 (91.2)	0.24
Hyperlipidemia	31 (86.1)	107 (82.9)	73 (88)	211 (85.1)	0.60
Diabetes mellitus	16 (44.4)	59 (45.4)	39 (47)	114 (45.8)	0.96
Cerebrovascular disease	3 (8.3)	10 (7.7)	6 (7.2)	19 (7.6)	0.98
Chronic lung disease	12 (33.3)	24 (18.5)	15 (18.1)	51 (20.5)	0.11
History of prior CAD	24 (66.7)	83 (63.8)	53 (64.6)	160 (64.5)	0.95
Peripheral arterial disease	5 (13.9)	15 (11.6)	5 (6.1)	25 (10.1)	0.31
Chronic kidney disease	11 (30.6)	28 (21.5)	20 (24.4)	59 (23.8)	0.53
Depression	16 (44.4)	42 (32.3)	29 (34.9)	87 (34.9)	0.40

Notes: The numbers in parentheses are standard deviations for continuous variables and percentages for categorical variables.

Abbreviations: CAD, coronary artery disease; MNCD, mild neurocognitive disorder; SLUMS, St Louis University Mental Status exam.

Table 2 REALM-R score and covariates

	Health illiterate	Normal	All	P-value
N subjects	85	165	250
Age	64.87 (8.16)	63.24 (9.47)	63.8 (9.07)	0.18
Sex – number male	85 (100)	159 (96.4)	244 (97.6)	0.18
Race – number white	55 (64.7)	139 (84.2)	194 (77.6)	<0.01
Smoking history	28 (32.9)	49 (30.1)	77 (31)	0.75
Hypertension	75 (88.2)	152 (92.7)	227 (91.2)	0.35
Hyperlipidemia	72 (85.7)	139 (84.8)	211 (85.1)	0.99
Diabetes mellitus	39 (45.9)	75 (45.7)	114 (45.8)	1.00
Cerebrovascular disease	7 (8.2)	12 (7.3)	19 (7.6)	0.99
Chronic lung disease	22 (25.9)	29 (17.7)	51 (20.5)	0.18
History of prior CAD	59 (69.4)	101 (62)	160 (64.5)	0.31
Peripheral arterial disease	8 (9.4)	17 (10.5)	25 (10.1)	0.96
Chronic kidney disease	18 (21.2)	41 (25.2)	59 (23.8)	0.59
Depression	36 (42.4)	51 (31.1)	87 (34.9)	0.10

Notes: The numbers in parentheses are standard deviations for continuous variables and percentages for categorical variables.

Abbreviations: CAD, coronary artery disease; REALM-R, Rapid Estimate of Adult Literacy in Medicine, Revised survey.

Figure 1 Medication adherence across SLUMS score.

Abbreviations: MNCD, mild neurocognitive disorder; SLUMS, St Louis University Mental Status exam.

Table 3 Relationship between SLUMS and REALM-R scores and medication nonadherence

	Unadjusted				Adjusted
	Probability nonadherent	OR	OR 95% CI	P-value	OR	OR 95% CI	P-value
SLUMS	–	–	–	0.017	–	–	0.01
Dementia	0.07	1.0	–	–	1.0	–	–
MNCD	0.35	7.7	1.4–144.2	–	12.2	1.9–243.0	–
Normal	0.18	3.0	0.5–58.2	–	4.8	0.6–101.5	–
REALM-R	–	–	–	0.92	–	–	0.85
Normal	0.25	1.0	0.4–2.3	–	1.1	0.4–3.0	–
Health illiterate	0.26	1.0	–	–	1.0	–	–
Race
Non-white	–	–	–	–	3.5	1.2–10.3	0.02
Diabetes
No history	–	–	–	–	2.7	1.0–8.0	0.06

Note: Table of multivariate model results for usual care.

Abbreviations: CI, confidence interval; MNCD, mild neurocognitive disorder; OR, odds ratio; REALM-R, Rapid Estimate of Adult Literacy in Medicine, Revised survey; SLUMS, St Louis University Mental Status exam.