Targeting cognitive function: Development of a cognitive training intervention for diabetes

Abstract

Aim: The aim of this project was to develop and demonstrate the feasibility of a comprehensive cognitive training intervention to build self-efficacy for implementation of cognitive strategies in people with diabetes. Background: People with diabetes are at greater risk than the general population for developing cognitive dysfunction. Some attention has been paid to the effect of cognitive impairments on diabetes self-management, but even when cognitive problems have been identified, few interventions have been tailored for those with diabetes. Methods: The intervention combines in-person classes and home-based online computer training. Development, in 2017, included (a) adaptation of prior established, tested interventions; (b) interviews with stakeholders; and (c) integration of course content. Results: Information provided by the stakeholders was used to modify an existing intervention to meet the needs of people with diabetes so that feasibility testing could occur. Despite initial difficulty with recruitment, the intervention was found to be feasible, and nineteen participants found it to be acceptable. Conclusion: This comprehensive cognitive training intervention targeting type 2 diabetes and cognitive dysfunction demonstrates that existing interventions can be adapted for use with people with diabetes.

Development and Use of a Tech-Based Data Management System for a Cognitive Rehabilitation Randomized Controlled Trial for People With Type 2 Diabetes

“…We acknowledge that the tech-based format could prevent some older adults from participating. However, our population had identified a tech-based intervention as preferable in prior studies 21 . Another limitation was that our system was limited to English readers/speakers, which could limit participation.…”

“…Multiple levels of security provided data security and integrity. This study also greatly benefited from being an adaptation of the previously successful MAPSS-MS project 17 and modified following our pilot study 6,21 . This provided a strong foundation in which to design this RCT.…”

“…Our principal goal in developing this management system was to facilitate the organization of data in distinct phases. We also intended to prioritize our target population's preferences for a tech-based design, 21 balanced with our ability to meet participants' needs of improving DM self-management, our budget, the research team's skills, and project sustainability 22 Table 1. provides a brief summary.…”

“…The overall objectives of the project were (1) to determine the effects of a comprehensive cognitive rehabilitation intervention on biological, cognitive, and DM self-management outcomes and (2) to explore changes in glycemic variability using CGMs and their association with changes in cognitive function (see Supplemental Figure, Study diagram, http://links.lww.com/CIN/A316). Additional details can also be found in our previously published work 6,18–21 …”

Imagining the future for diabetes nursing

“…Increasingly, as highly educated health professionals, nurses will have opportunities to play leading roles in health maintenance as well as disease management for patients with diabetes. With multimorbidity common with diabetes, nurses need skills in care and management of multiple diseases, providing education (Tang & Gao, 2019) and cognitive support (Cuevas, Stuifbergen, & Brown, 2020), applying competency and currency with health technologies. Already central to everyday nursing practice in many countries through point of care handheld computers, medication delivery devices and electronic medical records, the growth and spread of diabetes‐related technologies is leaving general, and not just specialist, nurses little choice but to develop proficiencies in this area.…”