Rebecca M Lovett1, Laura M Curtis2, Stephen D Persell3, James W Griffith4, Derin Cobia5, Alex Federman6, Michael S Wolf7. 1. Division of General Internal Medicine & Geriatrics, Feinberg School of Medicine, Northwestern University, 750 N. Lake Shore Drive, 10th Floor, Chicago, IL, USA. Electronic address: r-lovett@northwestern.edu. 2. Division of General Internal Medicine & Geriatrics, Feinberg School of Medicine, Northwestern University, 750 N. Lake Shore Drive, 10th Floor, Chicago, IL, USA. Electronic address: l-curtis@northwestern.edu. 3. Division of General Internal Medicine & Geriatrics, Feinberg School of Medicine, Northwestern University, 750 N. Lake Shore Drive, 10th Floor, Chicago, IL, USA. Electronic address: SPersell@nm.org. 4. Medical Social Sciences, Feinberg School of Medicine, Northwestern University, 645 N. Michigan Ave. #822, Chicago, IL, USA. Electronic address: j-griffith@northwestern.edu. 5. Department of Psychology and Neuroscience Center, Brigham Young University, Provo, UT, USA. Electronic address: derin_cobia@byu.edu. 6. General Internal Medicine, Icahn School of Medicine, Mount Sinai Hospital, 17 E 102nd St, 7th Floor, New York, NY, USA. Electronic address: alex.federman@mountsinai.org. 7. Division of General Internal Medicine & Geriatrics, Feinberg School of Medicine, Northwestern University, 750 N. Lake Shore Drive, 10th Floor, Chicago, IL, USA. Electronic address: mswolf@northwestern.edu.
Abstract
OBJECTIVES: To determine the prevalence of cognitive impairment no dementia (CIND) among a diverse, community-based population, and establish associations between CIND and health literacy, chronic disease self-management and functional health status. METHODS: 863 primary care adults without dementia aged 55-74. Adjusted logistic and linear regressions were used to assess associations between CIND (None, Mild, Moderate/Severe) and outcomes. RESULTS: 36 % participants exhibited CIND. It was strongly associated with limited health literacy (Newest Vital Signs: Mild [OR 3.25; 95 % CI 1.93, 5.49], Moderate/Severe [OR 6.45; 95 % CI 3.16, 13.2]; Test of Functional Health Literacy in Adults: Mild [OR 3.46; 95 % CI 2.08, 5.75], Moderate/Severe [OR 8.82; 95 % CI 4.87, 16.0]; all p's < 0.001) and poor chronic disease self-management (Mild [B = -11.2; 95 % CI -13.5, -8.90], Moderate/Severe CI [B = -21.0; 95 % CI -23.6, -18.4]; both p's < 0.001). Associations between CIND and functional health status were non-significant. CONCLUSIONS: CIND was prevalent in this cohort, and strongly associated with requisite skills for managing everyday health needs. PRACTICE IMPLICATIONS: Attention to subtle declines in chronic disease self-care may assist with CIND identification and care management within this population. When CIND is observed, clinicians should also expect and address difficulties with self-management.
OBJECTIVES: To determine the prevalence of cognitive impairment no dementia (CIND) among a diverse, community-based population, and establish associations between CIND and health literacy, chronic disease self-management and functional health status. METHODS: 863 primary care adults without dementia aged 55-74. Adjusted logistic and linear regressions were used to assess associations between CIND (None, Mild, Moderate/Severe) and outcomes. RESULTS: 36 % participants exhibited CIND. It was strongly associated with limited health literacy (Newest Vital Signs: Mild [OR 3.25; 95 % CI 1.93, 5.49], Moderate/Severe [OR 6.45; 95 % CI 3.16, 13.2]; Test of Functional Health Literacy in Adults: Mild [OR 3.46; 95 % CI 2.08, 5.75], Moderate/Severe [OR 8.82; 95 % CI 4.87, 16.0]; all p's < 0.001) and poor chronic disease self-management (Mild [B = -11.2; 95 % CI -13.5, -8.90], Moderate/Severe CI [B = -21.0; 95 % CI -23.6, -18.4]; both p's < 0.001). Associations between CIND and functional health status were non-significant. CONCLUSIONS: CIND was prevalent in this cohort, and strongly associated with requisite skills for managing everyday health needs. PRACTICE IMPLICATIONS: Attention to subtle declines in chronic disease self-care may assist with CIND identification and care management within this population. When CIND is observed, clinicians should also expect and address difficulties with self-management.
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