The Relationship Between Self-management Behavior And Cognitive Frailty In Elderly Patients With Type 2 Diabetes

Objective This study aimed to observe the general situation of self-management,cognitive frailty in elderly patients with type 2 diabetes and their relevant influencing factors.Here of the relationship between self-management behavior and cognitive frailty in elderly patients with type 2 diabetes could be analyzed.This would probably give a hint for the future study for the self-management behavior and cognitive frailty in diabetic patients.Methods A total of 290 elderly patients with type 2 diabetes were recruited randomly in the endocrinology and metabolism ward of a tertiary hospital in Anhui Province From January 2021 to January 2022.General information questionnaire,Type 2 Diabetes Self-care Scale(DSCS),FRAIL Scale,Minimental State Examination(MMSE),Clinical Dementia Rating(CDR),Activity Of Daily Living Scale(ADL)and 5-item Geriatric Depression Scale(GDS-5)survey were conveyed in our study.Epidata3.1 software was used to complete the data entry,and SPSS23.0 statistical software was used for data analysis.The descriptive data were carried out on the demographic data of patients and the scores of each questionnaire;the enumeration data were expressed by rate and constituent ratio;the measurement data were expressed by mean and standard deviation.Chi-square test,Spearman correlation coefficient,binary logistic regression analysis,etc.were subsequently conducted;to explore the relationship between self-management behavior and cognitive frailty in elderly patients with type 2 diabetes.Results(1)The age range of the elderly type 2 diabetes patients in this study was 60-88 years old.61.4% out of the whole population were aged 60-70 years old.There were 39 cases had no frailty,accounting for 13.4%.196 cases had pre-frailty,accounting for 67.6%.Fifty-five cases had physically frailty,accounting for 19%.There were 65 patients with cognitive impairment,accounting for 22.4%.There were 37 patients with cognitive frailty,accounting for 12.8%.Chi-square test showed that there was no significant difference between the level of cognitive frailty and the alcohol abusing history and sleeping quality(P>0.05).Nevertheless,the cognitive frailty were statistical differences with BMI,age,gender,education level,marital stutus,the type of medical insurance,monthly household income,smoking history,exercise habits,sleep duration,duration of diabetes,numbers of complicated chronic diseases,glycosylated hemoglobin,depression and self-management behavior(P<0.05).(2)The significant variables in the univariate analysis were later selected to binary logistic regression analysis.The results showed that educational level(β=-2.645,OR=0.07,95%CI:0.007-0.755,P<0.05)and sleep duration(β=-2.471,OR=0.084,95%CI:0.015-0.461,P<0.05)negatively ssociated with the level of cognitive frailty.The number of chronic diseases was positively relevant to cognitive frailty(β=2.110,OR=8.247,95%CI:2.065-32.934,P<0.05).Depression is a risk factor for cognitive frailty(β=2.962,OR=19.328,95%CI:2.021-184.875,P<0.05).The association bwtween the self-management behaviors and the incidence of cognitive frailty also reached significance(β=-7.821,OR=0.000,95%CI:0.000-0.026,P<0.05).(3)This study found that there was a statistically significant difference in the level of self-management behavior between patients with cognitively frailty and without cognitively frailty(P<0.05).The self-management behavior score index of patients with cognitive frailty was low(54.78±6.64)%,as compared to non-cognitively frailty patients(64.66±4.84)%.Patients in both groups scored the highest in taking medication as prescribed and lowest in blood glucose monitoring in questionnaire.(4)Spearman correlation coefficient analysis was conducted to analyze the relevance of self-management behavior and cognitive frailty of elderly patients with type 2 diabetes.The results showed that self-management behavior was negatively correlated with cognitive frailty(r=-0.747,P<0.05).Conclusions This study showed that elderly patients with type 2 diabetes had a low level of self-management and a higher incidence of cognitive frailty.Educational level,sleep duration,number of chronic diseases,depression degree,and self-management behavior were the influencing factors of cognitive frailty.The self-management behavior of elderly patients with type 2 diabetes was negatively correlated with cognitive frailty,which pinpointed the importance of self-management behavior,This might provide an evidence for the follow-up for cognitive frailty in diabetic patients.