Improving Glycemic Control in African Americans With Diabetes and Mild Cognitive Impairment.
Improving Glycemic Control in African Americans With Diabetes and Mild Cognitive Impairment.
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DOI：
10.1111/jgs.16339
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发表时间：
2020-05
影响因子：
6.3
通讯作者：
Leiby BE
中科院分区：
文献类型：
--
作者：
Rovner BW;Casten RJ;Piersol CV;White N;Kelley M;Leiby BE
随着人口老龄化和种族多样化，改善患有糖尿病和轻度认知障碍(MCI)的老年非裔美国人的血糖控制非常重要。随机对照试验。从城市学术医疗中心的初级保健诊所招聘。以社区为基础的治疗服务。老年非裔美国人患有MCI，服药依从性低，血糖控制差(N=101)。作业疗法(OT)行为干预和糖尿病自我管理教育。主要结果是在6个月时血红蛋白A1c水平至少降低0.5%，并在12个月时评估维持效果。在6个月时，41名OT参与者中的25名(61.0%)和46名糖尿病自我管理教育参与者中的22名(48.2%)的血红蛋白A1c水平至少下降了0.5%。模型估计率分别为58%(95%可信区间=45%−75%)和48%(95%CI=36%−%)(相对危险度[RR]=1.2 1；95%CI=0.84~1.75；P=.31)。在12个月时，39名OT参与者中有21名(53.8%)，49名糖尿病自我管理教育参与者中有24名(49.0%)。模型估计率分别为50%(95%CI=37%−68%)和48%(95%CI=36%−%)(RR=1.0 5；95%CI=0.70~1.5 7；P=.81)。这两种干预措施都改善了患有MCI和血糖控制不良的老年非裔美国人的血糖控制。这一结果加强了美国糖尿病协会ʼS评估老年糖尿病患者认知能力的建议，并展示了在这一高危人群中改善血糖控制的潜力。
Improving glycemic control in older African Americans with diabetes and mild cognitive impairment (MCI) is important as the population ages and becomes more racially diverse. Randomized controlled trial. Recruitment from primary care practices of an urban academic medical center. Community-based treatment delivery. Older African Americans with MCI, low medication adherence, and poor glycemic control (N = 101). Occupational therapy (OT) behavioral intervention and diabetes self-management education. The primary outcome was a reduction in hemoglobin A1c level of at least 0.5% at 6 months, with maintenance effects assessed at 12 months. At 6 months, 25 of 41 (61.0%) OT participants and 22 of 46 (48.2%) diabetes self-management education participants had a reduction in hemoglobin A1c level of at least 0.5%. The model-estimated rates were 58% (95% confidence interval [CI] = 45%−75%) and 48% (95% CI = 36%−64%), respectively (relative risk [RR] = 1.21; 95% CI = 0.84–1.75; P = .31). At 12 months, the respective rates were 21 of 39 (53.8%) OT participants and 24 of 49 (49.0%) diabetes self-management education participants. The model-estimated rates were 50% (95% CI = 37%−68%) and 48% (95% CI = 36%−64%), respectively (RR = 1.05; 95% CI = 0.70–1.57; P = .81). Both interventions improved glycemic control in older African Americans with MCI and poor glycemic control. This result reinforces the American Diabetes Associationʼs recommendation to assess cognition in older persons with diabetes and demonstrates the potential to improve glycemic control in this high-risk population.
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DOI：
10.1016/j.jalz.2011.03.005
发表时间：
2011-05
期刊：
Alzheimer's & dementia : the journal of the Alzheimer's Association
影响因子：
--
作者：
McKhann GM;Knopman DS;Chertkow H;Hyman BT;Jack CR Jr;Kawas CH;Klunk WE;Koroshetz WJ;Manly JJ;Mayeux R;Mohs RC;Morris JC;Rossor MN;Scheltens P;Carrillo MC;Thies B;Weintraub S;Phelps CH
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Phelps CH
影响因子：
14
作者：
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影响因子：
16.2
作者：
Mann, Devin M.;Ponieman, Diego;Halm, Ethan A.
通讯作者：
Halm, Ethan A.
影响因子：
4.2
作者：
Gonzalez, Jeffrey S.;Schneider, Havah E.
通讯作者：
Schneider, Havah E.
DOI：
10.1016/j.jalz.2011.03.008
发表时间：
2011-05
期刊：
Alzheimer's & dementia : the journal of the Alzheimer's Association
影响因子：
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作者：
Albert MS;DeKosky ST;Dickson D;Dubois B;Feldman HH;Fox NC;Gamst A;Holtzman DM;Jagust WJ;Petersen RC;Snyder PJ;Carrillo MC;Thies B;Phelps CH
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Phelps CH