Relationship Between Cognitive Impairment and Self-Management of Older Adults with Type 2 Diabetes

The purpose of this study was to investigate the relationships between cognitive function and self-management behaviors of older adults with type 2 diabetes. This dissertation document consists of two manuscripts. The first manuscript includes findings regarding the relationships between cognitive function and self-management behaviors in older adults with type 2 diabetes. The first set of specific aims were to (a) examine the relationships between executive function and diabetes self-management behaviors (DSMB) and (b) explore the effects of potential moderators (body mass index, depressive symptoms, and/or diabetes severity) on these relationships in older adults with type 2 diabetes. The second set of specific aims were to (a) explore the potential relationships between subjective cognitive function and DSMB and (b) explore potential moderating effects of the factors listed above on the relationships in this population. Bivariate correlation and multivariate linear regression analyses were used. The study results indicated that executive function was associated with DSMB, especially physician contact behaviors, whereas subjective cognitive function was not associated with any DSMB in the study sample. No moderating effects of the potential factors were identified on the relationships. Because the study was conducted amid the Coronavirus Disease 2019 (COVID-19) pandemic in 2020, the unique circumstances allowed additional investigation of psychological distress among older adults with type 2 diabetes. This investigation is documented in the second manuscript. The specific aim of this investigation was to examine the impact of COVID-19 worries on psychological distress among U.S. older adults with type 2 diabetes. The psychological distress addressed included diabetes distress and depression. Bivariate correlation and tobit regression analyses were used. The study results indicated that increased COVID-19 worries were associated with increased diabetes distress and depression in older adults with type 2 diabetes. Among the 4 diabetes distress subscales, emotional distress and regimen-related distress were significantly associated with COVID-19 worries after controlling for demographic and diabetes-related clinical factors.