Sidney Kimmel Medical College of Thomas Jefferson University, Philadelphia, PA, United States of America.
J Diabetes Complications. 2021 May;35(5):107905. doi: 10.1016/j.jdiacomp.2021.107905. Epub 2021 Mar 16.
Dementia, diabetes, and African American race are three factors that are independently associated with emergency department (ED) use. This study tested the hypothesis that ED use is associated with worse cognitive function in African Americans with Mild Cognitive Impairment (MCI) and poorly controlled diabetes.
This study examined differences in ED use among African Americans with MCI and diabetes in a secondary data analysis of baseline data from a one-year randomized controlled trial (N = 101).
Over one year, 49/92 participants (53.3%) had at least one ED visit. At baseline, participants who had an incident ED visit had significantly fewer years of education; lower scores on neuropsychological tests assessing working memory, psychomotor speed, and complex scanning; higher diabetes-related interpersonal distress scores; lower adherence to a diabetes medication; and higher hemoglobin A1c levels compared to participants with no ED visits (p ≤ 0.05 for all comparisons).
This study identified multiple risk factors for ED visits in older African Americans with MCI and diabetes. Targeted interventions may be necessary to reduce the need for ED care in high risk populations.
痴呆症、糖尿病和非裔美国人种族是与急诊科（ED）使用独立相关的三个因素。本研究检验了以下假设，即 ED 使用与患有轻度认知障碍（MCI）和糖尿病控制不佳的非裔美国人的认知功能下降有关。
本研究在一项为期一年的随机对照试验（N=101）的基线数据的二次数据分析中，检查了 MCI 和糖尿病的非裔美国人中 ED 使用的差异。
在一年中，92 名参与者中有 49 名（53.3%）至少有一次 ED 就诊。在基线时，发生 ED 就诊的参与者受教育年限明显较少；评估工作记忆、精神运动速度和复杂扫描的神经心理学测试得分较低；与无 ED 就诊者相比，糖尿病相关人际困扰评分较高；糖尿病药物治疗的依从性较低；血红蛋白 A1c 水平较高（所有比较的 p 值均≤0.05）。
本研究确定了 MCI 和糖尿病的老年非裔美国人 ED 就诊的多个风险因素。可能需要有针对性的干预措施来减少高危人群对 ED 护理的需求。
