Premium
Supporting a comprehensive and coordinated evaluation of the elderly with diabetes by integrating cognitive and physical assessment in the evaluation process
Author(s) -
Natovich Rachel,
Gayus Noa,
Azmon Michal,
Michal Hila,
Twito Omri Gury,
Yair Tomer,
Achiron Romi Noy,
Kraviz Neta,
Mordenfeld Nadia,
CukiermanYaffe Tali
Publication year - 2018
Publication title -
diabetes/metabolism research and reviews
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.307
H-Index - 110
eISSN - 1520-7560
pISSN - 1520-7552
DOI - 10.1002/dmrr.3030
Subject(s) - cognition , multidisciplinary approach , gerontology , population , medicine , diabetes mellitus , disease , cognitive decline , cognitive impairment , type 2 diabetes , psychology , physical therapy , dementia , psychiatry , environmental health , social science , pathology , sociology , endocrinology
Background Successful ageing with diabetes is challenged by co‐morbidities, which may present barriers to self‐care. Currently, measurement of physical and cognitive status is not part of routine care of the older person with diabetes, and these are not taken into account when devising the treatment plan. Objective To describe a novel approach that integrates cognitive and physical assessment into the routine evaluation of the older person with diabetes and the tailor‐made treatment plan devised accordingly. To provide estimates of the relative contribution of cognitive and physical disabilities in this population. Methods Cognitive and physical assessments were added to the standard evaluation. A composite measure of cognitive and of physical status categorizing each individual to intact, mild, or severe impairment was generated. In addition, all recommendations provided were categorized and tabulated. Results Of 119 individuals, over the age of 60 with type 2 diabetes who were referred because of difficulties in managing their disease, 16% and 3% of individuals met the criteria for severe cognitive/physical impairment, respectively, and 42% and 21% met the criteria for mild cognitive/physical impairment; 72%, 12.5%, 61% received recommendations related to intensification of physical activity, cognitive treatment, change in pharmacological agents, respectively. 25% were referred for further emotional treatment. Conclusions These data suggest that a substantial proportion of individuals with diabetes over the age of 60 may have cognitive/physical impairment. It highlights the importance of measuring these as part of the multidisciplinary evaluation and being able to provide a tailor made treatment plan.