Abstract
Purpose To describe the experiences of people with type 2 diabetes who have completed a comprehensive cognitive rehabilitation intervention. Method Nineteen participants with type 2 diabetes enrolled in an 8-week intervention consisting of 4 educational classes to learn strategies to improve cognitive function and an online training program at home to practice cognitively stimulating activities. Two focus groups were conducted as part of a study designed to assess the feasibility of the comprehensive cognitive rehabilitation intervention. Results Three main themes were identified in the qualitative data: (1) expectations of cognitive change; (2) use of cognitive strategies; and (3) effect on diabetes self-management. Participants shared valuable insight into how their experiences with the intervention changed and how they viewed diabetes. Conclusions While the participants did not initially tie their cognitive complaints to diabetes, they were able to show how and why they might use cognitive strategies to improve diabetes self-management activities. By adapting those strategies for diabetes, quality of life can improve as well as potentially glycemic control.
Highlights
Older adults with type 2 diabetes (T2DM) are at higher risk for dementia than those without T2DM, and once cognitive problems have been diagnosed, there is a potential for faster progression of cognitive decline [1]
Comprehensive cognitive rehabilitation interventions in other chronic conditions have been shown to be effective in improving function in daily life, but this has not been demonstrated in diabetes [9,10,11,12]
Participants often described not meeting the self-management standards that were set for them and felt that anything they could do to improve cognitive function would help with diabetes selfmanagement. e relationship of perceived cognitive function and diabetes self-management has been seen in the recent literature [13, 25] and suggests perceived executive function and memory capabilities are significantly associated with diabetes self-management adherence
Summary
Older adults with type 2 diabetes (T2DM) are at higher risk for dementia than those without T2DM, and once cognitive problems have been diagnosed, there is a potential for faster progression of cognitive decline [1]. Prior examinations have addressed self-management activities, but focused on only one aspect of diabetes selfmanagement and/or one cognitive domain and have had limited inclusion of underrepresented minority populations [5, 6]. Preliminary investigations have demonstrated connections between lower levels of perceived cognitive function (memory and executive function) and diabetes self-management adherence, but testing of cognitive rehabilitation interventions in diabetes is a novel and understudied focus. Practice and repetition (online computer training) can strengthen skills (e.g., memory, attention, and executive function), and these improvements can be translated into more complex functional behaviors through integration with compensatory strategies that are taught in person [8]. Comprehensive cognitive rehabilitation interventions in other chronic conditions have been shown to be effective in improving function in daily life, but this has not been demonstrated in diabetes [9,10,11,12]
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