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Cognitive Impairment in Diabetes: Rationale and Design Protocol of the Cog-ID Study.

Koekkoek PS, Janssen J, Kooistra M, van den Berg E, Kappelle LJ, Biessels GJ, Rutten GE - JMIR Res Protoc (2015)

Bottom Line: This research obtained funding and ethical approval.Enrolment started in August, 2012, and all study-related activities will be completed in September, 2016.With the results from this study, physicians will be able to detect cognitive impairment affecting type 2 diabetes patients through case-finding, and can use tailored care to reduce associated complications.

View Article: PubMed Central - HTML - PubMed

Affiliation: Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, Netherlands. p.s.koekkoek-3@umcutrecht.nl.

ABSTRACT

Background: Cognitive impairment frequently co-occurs with type 2 diabetes but is often undiagnosed. Cognitive impairment affects self-management leading to treatment-related complications.

Objective: The aim of this study is to develop a stepped diagnostic procedure, consisting of a screening test complemented by an evaluation by a general practitioner (GP), to detect undiagnosed cognitive impairment in older people with type 2 diabetes.

Methods: The accuracy of two self-administered cognitive tests, the "Test Your Memory" (TYM) and "Self-Administered Gerocognitive Examination" (SAGE) alone, and in combination with an evaluation by a GP will be assessed. A diagnosis of mild cognitive impairment (MCI) or dementia at a memory clinic will serve as reference standard. This cognitive impairment in diabetes (Cog-ID) study will include 513 people from primary care facilities aged ≥70 with type 2 diabetes. The participants will first fill out the TYM and SAGE tests, followed by a standardized GP evaluation for cognitive impairment, including a mini mental state examination (MMSE). Subsequently, participants suspected of cognitive impairment (on either test or the GP assessment) and a random sample of 15% (65/435) of participants without suspected cognitive impairment will be referred to the memory clinic. At the memory clinic, a medical examination, neuropsychological examination, and magnetic resonance imaging (MRI) of the brain will be performed. Participants will also fill out questionnaires assessing health status and depressive symptoms at baseline and after 6 and 24 months.

Results: This research obtained funding and ethical approval. Enrolment started in August, 2012, and all study-related activities will be completed in September, 2016.

Conclusions: With the results from this study, physicians will be able to detect cognitive impairment affecting type 2 diabetes patients through case-finding, and can use tailored care to reduce associated complications. Additionally, the results may stimulate discussions about cognitive impairment and whether early recognition is desirable.

No MeSH data available.


Related in: MedlinePlus

Study flowchart.
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figure1: Study flowchart.

Mentions: After the home visit, an independent physician, not involved in the home visit or in the memory clinic, will determine whether the participant will be selected for a visit to the memory clinic of the University Medical Centre Utrecht. To minimize the influence of the increasing experience of the research physician because of the growing number of home visits during the study period, the research physician who visited the participant at home will not be informed about the results of the memory clinic. The following 3 criteria will be used to decide whether a participant will be invited to the memory clinic (1) a classification of “suspected of cognitive impairment” by the research physician, (2) a score of ≤39 on the TYM, and (3) a score of ≤14 on the SAGE. When a participant scores positive on one of these criteria, the participant will be invited to the memory clinic. In addition, a random sample of 15% (65/435) of participants with negative scores on all 3 criteria will be invited to the memory clinic (see sample calculation below and Figure 1).


Cognitive Impairment in Diabetes: Rationale and Design Protocol of the Cog-ID Study.

Koekkoek PS, Janssen J, Kooistra M, van den Berg E, Kappelle LJ, Biessels GJ, Rutten GE - JMIR Res Protoc (2015)

Study flowchart.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4526928&req=5

figure1: Study flowchart.
Mentions: After the home visit, an independent physician, not involved in the home visit or in the memory clinic, will determine whether the participant will be selected for a visit to the memory clinic of the University Medical Centre Utrecht. To minimize the influence of the increasing experience of the research physician because of the growing number of home visits during the study period, the research physician who visited the participant at home will not be informed about the results of the memory clinic. The following 3 criteria will be used to decide whether a participant will be invited to the memory clinic (1) a classification of “suspected of cognitive impairment” by the research physician, (2) a score of ≤39 on the TYM, and (3) a score of ≤14 on the SAGE. When a participant scores positive on one of these criteria, the participant will be invited to the memory clinic. In addition, a random sample of 15% (65/435) of participants with negative scores on all 3 criteria will be invited to the memory clinic (see sample calculation below and Figure 1).

Bottom Line: This research obtained funding and ethical approval.Enrolment started in August, 2012, and all study-related activities will be completed in September, 2016.With the results from this study, physicians will be able to detect cognitive impairment affecting type 2 diabetes patients through case-finding, and can use tailored care to reduce associated complications.

View Article: PubMed Central - HTML - PubMed

Affiliation: Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, Netherlands. p.s.koekkoek-3@umcutrecht.nl.

ABSTRACT

Background: Cognitive impairment frequently co-occurs with type 2 diabetes but is often undiagnosed. Cognitive impairment affects self-management leading to treatment-related complications.

Objective: The aim of this study is to develop a stepped diagnostic procedure, consisting of a screening test complemented by an evaluation by a general practitioner (GP), to detect undiagnosed cognitive impairment in older people with type 2 diabetes.

Methods: The accuracy of two self-administered cognitive tests, the "Test Your Memory" (TYM) and "Self-Administered Gerocognitive Examination" (SAGE) alone, and in combination with an evaluation by a GP will be assessed. A diagnosis of mild cognitive impairment (MCI) or dementia at a memory clinic will serve as reference standard. This cognitive impairment in diabetes (Cog-ID) study will include 513 people from primary care facilities aged ≥70 with type 2 diabetes. The participants will first fill out the TYM and SAGE tests, followed by a standardized GP evaluation for cognitive impairment, including a mini mental state examination (MMSE). Subsequently, participants suspected of cognitive impairment (on either test or the GP assessment) and a random sample of 15% (65/435) of participants without suspected cognitive impairment will be referred to the memory clinic. At the memory clinic, a medical examination, neuropsychological examination, and magnetic resonance imaging (MRI) of the brain will be performed. Participants will also fill out questionnaires assessing health status and depressive symptoms at baseline and after 6 and 24 months.

Results: This research obtained funding and ethical approval. Enrolment started in August, 2012, and all study-related activities will be completed in September, 2016.

Conclusions: With the results from this study, physicians will be able to detect cognitive impairment affecting type 2 diabetes patients through case-finding, and can use tailored care to reduce associated complications. Additionally, the results may stimulate discussions about cognitive impairment and whether early recognition is desirable.

No MeSH data available.


Related in: MedlinePlus