| Objective: To understand the needs of elderly patients with type 2diabetes combined with mild cognitive impairment in the process of cognitive function management,and to construct a cognitive function management program for elderly patients with type 2 diabetes combined with mild cognitive impairment;to evaluate the effects of the cognitive function management program for elderly patients with type 2 diabetes combined with mild cognitive impairment on cognitive function,daily living ability and on blood glucose in elderly patients with type 2 diabetes combined with mild cognitive impairment.To evaluate the effect of cognitive function management program on cognitive function,daily living ability and glycemic control in elderly patients with type 2 diabetes combined with mild cognitive impairment.Methods: 1.To understand the needs of elderly patients with type 2diabetes mellitus combined with mild cognitive dysfunction in the process of cognitive function management by using qualitative interview method.Twelve elderly patients with type 2 diabetes mellitus combined with mild cognitive dysfunction were selected from the geriatric endocrinology department of a tertiary hospital in Nanning,Guangxi Zhuang Autonomous Region,and the needs of elderly patients with type2 diabetes mellitus combined with mild cognitive dysfunction in the process of cognitive function management were clarified through qualitative interviews to provide a realistic basis for program construction.2.Through systematic searches of domestic and international studies,systematic evaluations and guidelines on elderly patients with type 2diabetes mellitus combined with mild cognitive.The best research evidence was obtained by systematically searching relevant studies,systematic evaluations and guidelines on elderly patients with type 2diabetes mellitus combined with mild cognitive impairment,extracting and summarizing evidence,evaluating the quality of evidence,and obtaining the best research evidence.The Delphi method was used to evaluate the protocol,and suggestions were made to revise and improve the preliminary draft of the constructed cognitive function management protocol for elderly patients with type 2 diabetes combined with mild cognitive impairment.3.The preliminary application of the constructed cognitive function management protocol for elderly patients with type 2diabetes combined with mild cognitive impairment was conducted through class experimental studies.From August 15 to October 31,2021,64 patients who met the inclusion and exclusion criteria were selected from the geriatric endocrinology department of a tertiary care hospital in Nanning,Guangxi,and were divided into 32 cases in the control group and 32 cases in the experimental group according to the random number table method.The control group adopted conventional care measures for elderly patients with type 2 diabetes mellitus;the experimental group implemented the cognitive function management program constructed by the subject group for elderly patients with type 2 diabetes mellitus combined with mild cognitive dysfunction on the basis of conventional care.The Montreal Cognitive Inventory(Mo CA)and the Activities of Daily Living Scale(ADL)were used to assess the cognitive and life skills of the two groups.After 12 weeks of intervention,the changes of Mo CA score,ADL score,fasting blood glucose(FBG),2-hour postprandial blood glucose(2h PBG)and glycated hemoglobin(Hb A1c)values were compared between the two groups before and after the intervention.Results: 1.the needs of elderly patients with type 2 diabetes mellitus combined with mild cognitive dysfunction in the process of cognitive function management,a total of four themes were extracted: the need for disease knowledge,inadequate self-management,the need for social support and the need for continuity of care.2.The constructed cognitive function management program for elderly patients with type 2 diabetes mellitus combined with mild cognitive dysfunction,including early identification of mild cognitive dysfunction(screening for mild cognitive dysfunction,assessment of mild cognitive dysfunction),intervention for management of mild cognitive dysfunction,health education,and follow-up in 4 areas with a total of 34 recommended entries.3.64 patients were included in this study,3 cases were lost to follow-up,and the final control group patients 30 patients in the control group and 31 patients in the test group;the baseline data of the two groups were comparable(P > 0.05);after 12 weeks of intervention,the Mo CA scores of patients in the test group were significantly higher than those in the control group,and the difference was statistically significant(P < 0.05);after 12 weeks of intervention,the ADL scores in the test group were significantly lower than those in the control group,and the difference was statistically significant(P < 0.05);after 12 weeks of intervention,the After 12 weeks of intervention,FBG,2h PBG and Hb A1 c in the test group were significantly lower than those in the control group,and the difference was statistically significant(P < 0.05).Conclusion: 1.The needs of elderly patients with type 2 diabetes mellitus combined with mild cognitive impairment in the process of cognitive function management have not been met,and there is a need to construct a cognitive function management program for elderly patients with type 2 diabetes mellitus combined with mild cognitive impairment.2.This study combines the needs of patients for cognitive function management and the best research evidence to construct a scientific and feasible cognitive function management program for elderly patients with type 2 diabetes mellitus combined with mild cognitive impairment that is easy for patients to accept.3.The application of the cognitive function management program for elderly patients with type 2 diabetes mellitus combined with mild cognitive dysfunction can alleviate the development of cognitive impairment and improve patients’ ability to perform daily living. |
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