OBJECTIVES: To examine the role of cognitive impairment and caregiver support in diabetes care adherence and glycemic control. METHODS: Fifty-one veteran male outpatients (27 with caregivers) aged 60 years and older with type 2 diabetes were evaluated for cognitive impairment with the Cognitive Abilities Screening Instrument. Patients or caregivers completed diabetes self-care and depression scales. Medical morbidity information and HbA1c plasma levels at baseline and 1 year later were obtained from electronic medical records. RESULTS: Greater cognitive impairment (F = 5.1, p < .05), and presence of a caregiver (F = 5.3, p < .05), were independently associated with worse diabetes care adherence (adjusting for age, education, medical comorbidity, and depression). In addition, Mean HbA1c levels were worse in the cognitively impaired group with caregivers relative to the three other groups (F = 4.10, p < .05, eta2 = .09). One year later, mean HbA1c levels rose from 7.7 to 8.2% in the cognitively impaired group with caregivers. CONCLUSION: Cognitive impairment is associated with worse diabetes care management. Surprisingly, the presence of a caregiver is not protective. Further research is necessary to examine the healthcare needs of cognitively impaired, diabetic patients and their caregivers.
OBJECTIVES: To examine the role of cognitive impairment and caregiver support in diabetes care adherence and glycemic control. METHODS: Fifty-one veteran male outpatients (27 with caregivers) aged 60 years and older with type 2 diabetes were evaluated for cognitive impairment with the Cognitive Abilities Screening Instrument. Patients or caregivers completed diabetes self-care and depression scales. Medical morbidity information and HbA1c plasma levels at baseline and 1 year later were obtained from electronic medical records. RESULTS: Greater cognitive impairment (F = 5.1, p < .05), and presence of a caregiver (F = 5.3, p < .05), were independently associated with worse diabetes care adherence (adjusting for age, education, medical comorbidity, and depression). In addition, Mean HbA1c levels were worse in the cognitively impaired group with caregivers relative to the three other groups (F = 4.10, p < .05, eta2 = .09). One year later, mean HbA1c levels rose from 7.7 to 8.2% in the cognitively impaired group with caregivers. CONCLUSION:Cognitive impairment is associated with worse diabetes care management. Surprisingly, the presence of a caregiver is not protective. Further research is necessary to examine the healthcare needs of cognitively impaired, diabeticpatients and their caregivers.
Authors: Mary Beth Spitznagel; Sarah Garcia; Lindsay A Miller; Gladys Strain; Michael Devlin; Rena Wing; Ronald Cohen; Robert Paul; Ross Crosby; James E Mitchell; John Gunstad Journal: Surg Obes Relat Dis Date: 2011-10-29 Impact factor: 4.734
Authors: Priya Palta; Sherita H Golden; Jeanne Teresi; Walter Palmas; Ruth S Weinstock; Steven Shea; Jennifer J Manly; Jose A Luchsinger Journal: J Am Geriatr Soc Date: 2014-11-29 Impact factor: 5.562
Authors: John Gunstad; Gladys Strain; Michael J Devlin; Rena Wing; Ronald A Cohen; Robert H Paul; Ross D Crosby; James E Mitchell Journal: Surg Obes Relat Dis Date: 2010-10-30 Impact factor: 4.734
Authors: Mary Beth Spitznagel; Michael Alosco; Gladys Strain; Michael Devlin; Ronald Cohen; Robert Paul; Ross D Crosby; James E Mitchell; John Gunstad Journal: Surg Obes Relat Dis Date: 2013-05-06 Impact factor: 4.734