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.
Similar content being viewed by others
References
Langa K, Larson EB, Crimmins EM et al. A comparison of the prevalence of dementia in the United States in 2000 and 2012. JAMA Internal Medicine. Published online November 21, 2016. doi:10.1001/jamainternmed.2016.6807
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, Jun;13(3):277–84. doi: 10.1177/1474515113492603. Epub 2013 Jun3.
Shaw RJ, McDuffie JR, Hendrix CC, Edie A, Lindsey-Davis L, Williams JW. 2013 Aug. Effects of Nurse-Managed Protocols in the Outpatient Management of Adults with Chronic Conditions [Internet]. Washington (DC): Department of Veterans Affairs; VA Evidence-based Synthesis Program Reports.
American Psychiatric Association 2013. Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5). Washington, DC: Author.
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):712–22.
Borson S. The mini-cog: a cognitive “vital signs” measure for dementia screening in multi-lingual elderly. Int J Geriatr Psychiatry; 2000;15(11):1021.
Nasreddine Z. 2003) The Montreal Cognitive Assessment. http://www.mocatest.org/Accessed 9/16/14.
Wechsler, D. (1997) Wechsler Memory Scale, 3rd Edition. San Antonio, TX: PsychCorp.
Delis DC, Kramer JH, Kaplan E, Ober BA. 2000. California Verbal Learning Test, 2nd Edition. San Antonio, TX: Pearson, 2000.
Yesavage JA. 1988. Geriatric Depression Scale. Psychopharmacol Bull. 24(4):709–11.
Wilson BA, Greenfield E, Clare L, et al. Rivermead Behavioral Memory Test. Pearson, 2008.
Brandt J & Folstein M. Telephone Interview for Cognitive Status. Lutz, FL: Psychological Assessment Resources, 1988.
Radloff LS. The CES-D scale: a self-report depression scale for research in the general population. Applied Psychol Meas. 1977;3:385–401. doi: 10.1177/014662167700100306.
IBM Corp. Released 2013. IBM SPSS Statistics for Windows, Version 22.0. Armonk, NY: IBM Corp.
StataCorp. 2013. Stata Statistical Software: Release 13. College Station, TX: StataCorp LP
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Bonner, L.M., Hanson, A., Robinson, G. et al. Care Management to Promote Treatment Adherence in Patients with Cognitive Impairment and Vascular Risk Factors: A Demonstration Project. J Prev Alzheimers Dis 5, 36–41 (2018). https://doi.org/10.14283/jpad.2017.28
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.14283/jpad.2017.28