Improving Care for Nursing Home residents with Diabetes and Cognitive Impairment

改善对患有糖尿病和认知障碍的疗养院居民的护理

• 批准号: 10328473
• 负责人: Sei Lee
• 金额: $ 18.16万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-01-15 至 2025-12-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10328473
• 关键词: Admission activity; Aging; Alzheimer' s disease related dementia; American; Benefits and Risks; Caring; Clinical; Clinical Research; Cognitive; Data; Data Set; Dementia; Dependence; Diabetes Mellitus; Elderly; Electronic Health Record; Faculty; Funding; Future; Glucose; Glycosylated hemoglobin A; Goals; Guidelines; Home Nursing Care; Hypoglycemia; Impaired cognition; Insulin; Intervention; Investigator-Initiated Research; Laboratories; Lead; Leadership; Life Expectancy; Link; Measurement; Measures; Mentors; Mentorship; Metformin; Microvascular Dysfunction; Modeling; Monitor; Nursing Homes; Outcome; Patients; Persons; Pharmaceutical Preparations; Pharmacoepidemiology; Population; Public Health; Publishing; Research; Research Personnel; Research Support; Risk; Severities; Symptoms; System; Time; United States Department of Veterans Affairs; Validation; Veterans; Work; adverse outcome; care outcomes; career; career development; clinical care; clinical practice; colorectal cancer screening; disadvantaged background; evidence base; glucose monitor; high risk; improved; improved outcome; interest; mortality; nursing home length of stay; older patient; overtreatment; personalized care; programs; skills

Public Health Significance: Nursing home (NH) residents with diabetes and Alzheimer’s disease and related dementias are a large, growing population at high risk for adverse outcomes. Unfortunately, little is known about current clinical care practices or the outcomes that result from those care practices in NH residents with diabetes and Alzheimer’s disease and related dementias. The proposed studies will examine those clinical practices and outcomes in NH residents with diabetes across the spectrum of severity of Alzheimer’s disease and related dementias. Research Aims: The proposed projects will compare the rates of fingerstick glucose measurement across the spectrum of severity of Alzheimer’s disease and related dementias (Aim 1), compare the rates of mild hypoglycemia (defined as American Diabetes Association or ADA level 1: glucose 70-54 mg/dL) and moderate hypoglycemia (ADA level 2: glucose <54 mg/dL) across the spectrum of severity of Alzheimer’s disease and related dementias (Aim 2) and determine the rates of likely glycemic overtreatment (defined as use of insulin with hemoglobin A1c or HbA1c <7.5%) and likely glycemic undertreatment (defined as use of no medications or metformin only with HbA1c >9.0%) across the spectrum of severity of Alzheimer’s disease and related dementias in long-stay nursing home residents (Aim 3). Candidate’s Career Development and Mentoring Plan: The candidate proposes to expand his successful mentorship program, taking on additional mentees to help complete the proposed projects. The candidate will continue to develop as a researcher by expanding his skills in NH research focusing on the large number of NH residents with Alzheimer’s disease and related dementias. The candidate will continue to develop as a mentor by building leadership skills and focusing on supporting mentees from disadvantaged backgrounds. Candidate’s Career Goals: Candidate’s long-term goals are to become a national leader in aging research focusing on NH residents with Alzheimer’s disease and related dementias, while becoming a pre-eminent mentor in aging research.

公共卫生意义：患有糖尿病、阿尔茨海默病和相关痴呆的养老院（NH）居民是一个庞大的、不断增长的不良后果高风险人群。不幸的是，人们对目前的临床护理实践或这些护理实践对患有糖尿病、阿尔茨海默病和相关痴呆症的NH居民的结果知之甚少。拟议的研究将检查这些临床实践和结果在NH居民糖尿病阿尔茨海默病和相关痴呆的严重程度的范围。