Diabetology & Metabolic Syndrome (Feb 2019)

People with type 2 diabetes and screen-detected cognitive impairment use acute health care services more often: observations from the COG-ID study

  • Jolien Janssen,
  • Paula S. Koekkoek,
  • Geert Jan Biessels,
  • L. Jaap Kappelle,
  • Guy E. H. M. Rutten,
  • the Cog-ID study group

DOI
https://doi.org/10.1186/s13098-019-0416-z
Journal volume & issue
Vol. 11, no. 1
pp. 1 – 10

Abstract

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Abstract Background Patients with type 2 diabetes have an increased risk of cognitive impairment which can lead to impaired diabetes self-management and an increased risk of diabetes-related complications. Routine screening for cognitive impairment in elderly patients with type 2 diabetes is therefore increasingly advocated. The aim of this study is to investigate whether people with type 2 diabetes and screen-detected cognitive impairment use acute health care services more often than patients not suspected of cognitive impairment. Methods People with type 2 diabetes ≥ 70 years were screened for cognitive impairment in primary care. Diagnoses in screen positives were established at a memory clinic. Information about acute health care use was collected for 2 years prior to and 2 years after screening and compared to screen negatives. Results 154 participants (38% female, mean age 76.7 ± 5.2 years, diabetes duration 8.7 ± 8.2 years) were included, 37 patients with cognitive impairment, 117 screen negatives. A higher percentage of participants with cognitive impairment compared to screen negative patients used acute health care services; this difference was significant for general practitioner’s out of hours services (56% versus 34% used this service over 4 years, p = 0.02). The mean number of acute health care visits was also higher in those with cognitive impairment than in screen negatives (2.2 ± 2.8 versus 1.4 ± 2.2 visits in 4 years, p < 0.05; 1.4 ± 2.2 versus 0.7 ± 1.5 visits in 2 years after screening, p = 0.03). Factors that could have played a role in this increased risk of acute health care services use were a low educational level, the presence of depressive symptoms (CES-D score ≥ 16), self-reported problems in self-care and self-reported problems in usual activities. Conclusions People with type 2 diabetes and screen-detected cognitive impairment use acute health care services more often.

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