Forgotten Prescriptions: A Single Case Study on Medication Non-Adherence and Cognitive Decline

Abstract

Hypertension remains one of the leading causes of cardiovascular and cerebrovascular morbidity and mortality worldwide. Medication non-adherence and dependence on alternative remedies continue to contribute to poor health outcomes, particularly among adults with chronic illnesses. This case study explored the progression of uncontrolled hypertension in a 48-year-old male storekeeper who gradually discontinued prescribed antihypertensive medication in favor of herbal tea and gel capsules believed to reduce blood pressure. Despite initial medical advice to maintain Amlodipine 10 mg daily following a blood pressure reading of 140/100 mmHg in 2019, the patient eventually stopped regular consultation and relied heavily on herbal alternatives during and after the COVID-19 pandemic. Over time, the patient developed cognitive and behavioral changes suggestive of vascular-related cognitive decline, including memory impairment, disorientation, hallucinations, poor judgment, and functional deterioration. Family members reported increasing resistance to medical consultation and inconsistent medication adherence. In 2024, the patient experienced cardiac arrest and subsequently died after hospitalization. This case highlights the possible consequences of prolonged uncontrolled hypertension, poor treatment adherence, health misinformation, and delayed healthcare consultation. The study supports national and regional health priorities on non-communicable diseases, health literacy, chronic disease management, and preventive healthcare interventions.