Aims: To determine whether psychological, sleep, and diabetes-related factors were associated with subjective cognitive decline (SCD) in adults with type 2 diabetes (T2D).
Design: A secondary analysis with a cross-sectional, correlational design.
Methods: Data from two parent studies were combined. A total of 105 adults with diabetes were recruited from a Midwestern city in the United States from September 2013-March 2014 and September 2016-September 2017. Subjective cognitive decline was measured with the psychological-cognitive symptom subscale of the Diabetes Symptom Checklist-Revised. Psychological factors (diabetes distress, fatigue, and depressive symptoms) and sleep were measured using the Diabetes Distress Scale and Patient-Reported Outcomes Measurement Information System. Diabetes-related factors were measured with body mass index and glycaemia control. Quantile regression was used to examine the associations.
Results/findings: The mean age of the participants was 58.10 (SD 7.92) years and 58.1% were women. The participants' mean psychological-cognitive symptom score was 1.41 (SD 1.13). After controlling for age and gender, sleep disturbance, sleep-related impairment, and body mass index were associated with SCD in lower cognitive symptom quantile groups (5th to 30th percentiles). In contrast, fatigue and depressive symptoms were more strongly associated with SCD in higher quantile groups (70th to 95th percentiles).
Conclusion: In adults with T2D, SCD was differentially associated with psychological, sleep, and diabetes-related factors depending on cognitive symptom percentiles. Adults with T2D require regular screening for SCD. If they complain of cognitive symptoms at clinical visits, different underlying factors should be assessed according to their symptom severity.
Impact: Findings from this study provided evidence for early identification of SCD and its influencing factors, which may help to develop nursing interventions to recognize and/or delay the onset of cognitive impairment in adults with T2D.
目的: 确定2型糖尿病(T2D)成年患者的心理、睡眠和糖尿病相关因素是否与主观认知下降(SCD)有关。 设计: 横向相关性设计的二次分析。 方法: 结合了来自两组主要研究的数据。2013年9月至2014年3月以及2016年9月至2017年9月期间,在美国中西部招募了105名糖尿病成年患者。之后,通过糖尿病症状检查表(修订版)的心理认知症状子量表测量了主观认知下降水平。通过糖尿病疼痛量表和患者报告结果测量信息系统测量了心理因素(糖尿病疼痛、疲劳和抑郁症状)以及睡眠因素。通过身体质量指标和血糖控制测量了糖尿病相关因素。最后采用分位数回归的方法检查其相关性。 结果/发现: 参与者平均年龄为58.10(SD 7.92)岁。其中,女性占参与者总人数的58.1%。参与者平均心理认知症状评分为1.41 (SD 1.13)。在认知症状分位数较低(5到30个百分位)的分组中,控制年龄和性别后,主观认知下降与睡眠干扰、睡眠相关障碍以及身体质量指标有关。相反,在分位数较高的分组中(70到95个百分位),主观认知下降与疲劳和抑郁症状有很大的关联。 结论: 在T2D成年患者中,随着认知症状百分位的不同,主观认知下降与心理、睡眠和糖尿病相关因素有着不同的相关性。T2D成年患者需要定期筛查主观认知下降。如果其在就诊时述说有认知症状,根据其不同的认知严重程度,评估不同的潜在因素。 影响: 本研究结果为早期发现主观认知及其影响因素提供了证据,有助于制定护理干预措施,以识别和/或延迟T2D成年患者主观认知障碍的出现。.
Keywords: cognitive impairment; depression; diabetes distress; fatigue; gerontological nursing; nurse; older adults; sleep; subjective cognitive decline; type 2 diabetes.
© 2020 John Wiley & Sons Ltd.