TY - JOUR
T1 - Cognitive impairment no dementia and associations with health literacy, self-management skills, and functional health status
AU - Lovett, Rebecca M.
AU - Curtis, Laura M.
AU - Persell, Stephen D.
AU - Griffith, James W.
AU - Cobia, Derin
AU - Federman, Alex
AU - Wolf, Michael S.
N1 - Funding Information:
SDP receives research support from Omron Healthcare and previously received grant support from Pfizer, Inc. MSW receives research funding from Amgen and Merck, Sharpe & Dohme. He also has served as a paid consultant to Luto U.K., Pfizer and AB Imbev Foundation. RML, LMC, JWG, DC and AF have no conflicts of interest to disclose.
Publisher Copyright:
© 2020 Elsevier B.V.
PY - 2020/9
Y1 - 2020/9
N2 - 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.
AB - 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.
KW - Chronic disease self-management
KW - Cognitive impairment
KW - Functional health status
KW - Health literacy
KW - Older adults
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U2 - 10.1016/j.pec.2020.03.013
DO - 10.1016/j.pec.2020.03.013
M3 - Article
C2 - 32197929
AN - SCOPUS:85081895732
VL - 103
SP - 1805
EP - 1811
JO - Patient Education and Counseling
JF - Patient Education and Counseling
SN - 0738-3991
IS - 9
ER -