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Effective disease management in older adults relies on medication adherence to prevent adverse outcomes like hospitalization, particularly among those with cognitive impairment. In this study, we examined the impact of cognitive impairment on medication management, adherence, and hospitalization risk across levels of cognitive function. Analyzing data from 28,558 community-dwelling older adults, we found that those with dementia had the most difficulty managing medications (13.12%), followed by cognitive impairment without dementia (5.80%), and intact cognition (1.96%). Only persons with dementia showed a significant association between medication management difficulty and hospitalization risk (Odds Ratio [OR] = 1.71; 95% Confidence Intervals: 1.08, 2.70; p =.02). Cost-related medication nonadherence was associated with hospitalization risk solely among those with intact cognition (OR = 1.25; 95% CI: 1.07, 1.45; p =.004). Dementia was associated with higher odds of medication management difficulty and subsequently hospitalization risk, underscoring the need for resources to support medication use for this population. [ABSTRACT FROM AUTHOR]

Recently, redox chemical transformations have been reported to occur spontaneously in microdroplets. The origins of such novel reactivity are still debated, and any systematic correlation of the oxidative/reductive yield with the reactivity of the reactant is yet to be established. Towards this end, we report the simple, outer-sphere, one-electron oxidation of a series of ferrocene derivatives spanning a range of oxidation potentials from -0.1 V to +0.8 V vs. Ag/AgCl in acetonitrile microdroplets generated via nebulization and measured by mass spectrometry of the corresponding ferrocenium ions. The reaction environments and dynamics in the droplets are complex, and it is still unclear whether such reactivity correlates with any bulk thermodynamic values. Our key finding is that the ion yields decrease monotonically with the oxidation potential of the ferrocenes, which is a thermodynamic quantity. The ion yields emphatically do not obey the Nernstian ratio, revealing the redox processes in the droplets do not follow the assumptions of bulk steady-state electrochemistry. Furthermore, oxidative competition in the mixture of several ferrocenes suggest a finite oxidative capacity or oxidant concentration. These results demonstrate that even though ion generation could be an out-of-equilibrium and kinetically limited process, the oxidative yield in microdroplets does correlate with thermodynamics, suggesting a possible free energy relationship between the kinetics and thermodynamics of the process., (© 2024 Wiley-VCH GmbH.)