Care Management to Promote Treatment Adherence in Patients with Cognitive Impairment and Vascular Risk Factors: A Demonstration Project
- PMID: 29405231
- PMCID: PMC12280818
- DOI: 10.14283/jpad.2017.28
Care Management to Promote Treatment Adherence in Patients with Cognitive Impairment and Vascular Risk Factors: A Demonstration Project
Abstract
Dementia prevention is highly important. Improved control of vascular risk factors has the potential to decrease dementia risk, but may be difficult. Therefore, we developed and piloted a care management protocol for Veterans at risk for dementia. We enrolled 32 Veterans with diabetes and hypertension, at least one of which was poorly controlled, and cognitive impairment. Participants were randomly assigned to a 6-month care management intervention or to usual care. At enrollment, 6-months and 12-months, we assessed cognitive performance, mood, and diabetes and hypertension control. At follow-up, diastolic blood pressure was lower in intervention participants at 6 months (p=.041) and 12 months (p=.022); hemoglobin A1c, global mental status and mood did not differ between groups. Recall of a distractor list (p=.006) and logical memory long-delay recall (p=.036) were better at 6 months in the intervention group (p=.006). Care management may contribute to improved control of dementia risk factors.
Keywords: Dementia, prevention; care management; chronic disease; hypertension; treatment adherence; type 2 diabetes.
Conflict of interest statement
There are no conflicts of interest for any of the authors.
References
-
- Harkness K, Heckman GA, Akhtar-Danesh N, Demers C, Gunn E, McKelvie RS. Cognitive function and self-care management in older patients with heart failure. Eur J Cardiovasc Nurs. 2014;13(3):277–284. 10.1177/1474515113492603 PubMed PMID: 23733350. - DOI - PubMed
-
- Shaw RJ, McDuffie JR, Hendrix CC, Edie A, Lindsey-Davis L, Williams JW. Department of Veterans Affairs; Washington (DC): 2013. Effects of Nurse-Managed Protocols in the Outpatient Management of Adults with Chronic Conditions [Internet] - PubMed
-
- American Psychiatric Association . Author; Washington, DC: 2013. Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5)
-
- Raskin J, Cummings J, Hardy J, Schuh K, Dean RA. Neurobiology of Alzheimer's Disease: Integrated molecular, physiological, anatomical, biomarker, and cognitive dimensions. Curr Alzheimer Res. 2015;12(8):712–722. 10.2174/1567205012666150701103107 PubMed PMID: 26412218, PMCID 5384474. - DOI - PMC - PubMed
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