Cognitive impairment no dementia and associations with health literacy,self-management skills,and functional health status |
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| Affiliation: | 1. Division of General Internal Medicine & Geriatrics, Feinberg School of Medicine, Northwestern University, 750 N. Lake Shore Drive, 10th Floor, Chicago, IL, USA;2. Medical Social Sciences, Feinberg School of Medicine, Northwestern University, 645 N. Michigan Ave. #822, Chicago, IL, USA;3. Department of Psychology and Neuroscience Center, Brigham Young University, Provo, UT, USA;4. General Internal Medicine, Icahn School of Medicine, Mount Sinai Hospital, 17 E 102nd St, 7th Floor, New York, NY, USA;1. RTI International, Research Triangle Park, NC, USA;2. US Food and Drug Administration, Silver Spring, MD, USA;1. Cancer Prevention and Control Program, Fox Chase Cancer Center, Philadelphia, PA, USA;2. Department of Social and Behavioral Sciences, College of Public Health, Temple University, Philadelphia, USA;3. Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, USA;1. Université Libre de Bruxelles, Faculté des Sciences Psychologiques et de l’Éducation, Brussels, Belgium;2. Institut Jules Bordet, Clinique de Psycho-Oncologie, Université Libre de Bruxelles, Brussels, Belgium;3. Hôpital Universitaire Erasme, Service de Psychologie, Brussels, Belgium;4. Centre de Psycho-Oncologie, Brussels, Belgium;5. Université Catholique de Louvain, Faculté de Médecine, Brussels, Belgium;1. Johns Hopkins University School of Medicine, Baltimore, MD, USA;2. Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA;3. Berman Institute of Bioethics, Johns Hopkins University, Baltimore, MD, USA;4. Department of Medicine, Oregon Health and Science University, Portland, OR, USA;5. Center to Improve Veteran Involvement in Care, VA Portland Health Care System, Portland, OR, USA;1. Institute for Medical Education, University Hospital, LMU Munich, Germany;2. Faculty of Behavioural and Social Sciences, Department of Educational Sciences, University of Groningen, the Netherlands;3. Lehrstuhl für die Ausbildung personaler und interpersonaler Kompetenzen im Gesundheitswesen, Fakultät für Gesundheit, Universität Witten/Herdecke, Witten, Germany |
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| Abstract: | ObjectivesTo 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.Methods863 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.Results36 % 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.ConclusionsCIND was prevalent in this cohort, and strongly associated with requisite skills for managing everyday health needs.Practice ImplicationsAttention 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. |
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| Keywords: | Older adults Cognitive impairment Health literacy Chronic disease self-management Functional health status |
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