Cognitive impairment no dementia and associations with health literacy, self-management skills, and functional health status

PATIENT EDUCATION AND COUNSELING

卷:103

Article

Lovett, Rebecca M.¹  Curtis, Laura M.¹  Persell, Stephen D.¹  Griffith, James W.²  Cobia, Derin^3,4  Federman, Alex⁵  Wolf, Michael S.¹ 

[1] Northwestern Univ, Feinberg Sch Med, Div Gen Internal Med & Geriatr, 750 N Lake Shore Dr,10th Floor, Chicago, IL 60611 USA

[2] Northwestern Univ, Feinberg Sch Med, Med Social Sci, 645 N Michigan Ave 822, Chicago, IL 60611 USA

[3] Brigham Young Univ, Dept Psychol, Provo, UT 84602 USA

[4] Brigham Young Univ, Neurosci Ctr, Provo, UT 84602 USA

[5] Mt Sinai Hosp, Icahn Sch Med, Gen Internal Med, 17 E 102nd St,7th Floor, New York, NY 10029 USA

关键词: Older adults;    Cognitive impairment;    Health literacy;    Chronic disease self-management;    Functional health status;   

DOI  :  10.1016/j.pec.2020.03.013

来源: Elsevier

【 摘 要 】

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. (C) 2020 Elsevier B.V. All rights reserved.

【 授权许可】

Free