Świątoniowska-Lonc Natalia, Polański Jacek, Tański Wojciech, Jankowska-Polańska Beata
Department of Clinical Nursing, Faculty of Health Science, Wroclaw Medical University, Wroclaw, Poland.
Department of Internal Diseases, Occupational Medicine, Hypertension and Clinical Oncology, Wroclaw Medical University, Wroclaw, Poland.
Diabetes Metab Syndr Obes. 2021 Jan 15;14:193-203. doi: 10.2147/DMSO.S284468. eCollection 2021.
Elderly patients with diabetes have a significantly increased prevalence of mild cognitive impairment compared with people of similar age without diabetes. Tasks related to diabetes self-management involve multiple cognitive skills and processes, such as memory, attention, planning, and calculating. Impaired cognitive function can threaten the patient's ability to perform self-monitoring. The objectives of the study were: to assess cognitive deficits and the level of self-care in elderly patients with diabetes, to identify correlations between cognitive deficits and self-care, and to determine which variables influence self-care behaviors and cognitive deficits.
The study involved 169 patients with type 2 DM. Standardized tools were used: Mini-mental State Examination (MMSE) to assess cognitive function and the Self-Care of Diabetes Inventory (SCODI) to assess the level of self-care. Socioclinical data were taken from the hospital records.
56.8% of patients had cognitive impairment (MMSE≤26). In the comparative analysis, patients with cognitive impairment had significantly lower results in all domains of the SCODI: self-care maintenance (72.9 vs 75), self-care monitoring (53.1 vs 56.3), self-care management (71.9 vs 84.4), self-care confidence (79.5 vs 86.4). Correlation analysis showed that the MMSE score correlates significantly and positively (p˂0.05; r˃0) with all SCODI subscales, and the higher the MMSE score the higher the level of self-care (A: r=0.252, B: r=0.244, C: r=0.019, D: r=0.28).
In this elderly type 2 diabetes population, and using only one test to verify the cognitive function, self-care management was worse in terms of self-care management (blood glucose control). Cognitive function components are independent determinants of self-care in patients with type 2 diabetes. Recall is an independent predictor of self-care maintenance, and writing a predictor of self-care monitoring.
与年龄相仿的非糖尿病患者相比，老年糖尿病患者轻度认知障碍的患病率显著增加。糖尿病自我管理相关任务涉及多种认知技能和过程，如记忆、注意力、规划和计算。认知功能受损会威胁患者进行自我监测的能力。本研究的目的是：评估老年糖尿病患者的认知缺陷和自我护理水平，确定认知缺陷与自我护理之间的相关性，并确定哪些变量影响自我护理行为和认知缺陷。
该研究纳入了169例2型糖尿病患者。使用了标准化工具：简易精神状态检查表（MMSE）评估认知功能，糖尿病自我护理量表（SCODI）评估自我护理水平。社会临床数据取自医院记录。
56.8%的患者存在认知障碍（MMSE≤26）。在比较分析中，认知障碍患者在SCODI的所有领域得分均显著较低：自我护理维持（72.9对75）、自我护理监测（53.1对56.3）、自我护理管理（71.9对84.4）、自我护理信心（79.5对86.4）。相关性分析表明，MMSE评分与SCODI所有子量表均呈显著正相关（p˂0.05；r˃0），MMSE评分越高，自我护理水平越高（A：r=0.252，B：r=0.244，C：r=0.019，D：r=0.28）。
在这个老年2型糖尿病人群中，仅使用一项测试来验证认知功能，自我护理管理（血糖控制方面）较差。认知功能成分是2型糖尿病患者自我护理的独立决定因素。回忆是自我护理维持的独立预测因素，书写是自我护理监测的预测因素。
