scholarly journals Motivational Strategies to Prevent Frailty in Older Adults with Diabetes: A Focused Review

2019 ◽  
Vol 2019 ◽  
pp. 1-8 ◽  
Author(s):  
J. A. Vaccaro ◽  
T. Gaillard ◽  
F. G. Huffman ◽  
E. R. Vieira
Keyword(s):  
Type 2 Diabetes ◽  
Older Adults ◽  
Health Behavior ◽  
Lifestyle Changes ◽  
Health Care Use ◽  
Behavior Changes ◽  
Motivational Strategies ◽  
Frail Older Adults ◽  
Health Behavior Changes

The prevalence of diabetes among Americans aged 65 years and older is greater than 25%. Medical expenditures for persons with diabetes are more than twice as high as those for patients without diabetes. Diabetes in older adults often times coexists with frailty, resulting in reduced quality of life and increased health-care use. Many older adults with type 2 diabetes have mobility impairments and experience falls, which contributes to increased frailty. Exercise has a protective effect for frailty and falls, yet less than half of persons with diabetes exercise and approximately one-quarter meet exercise recommendations. In addition to exercise, nutrition may help reduce the risk for falls; however, nutritional interventions have not been tested as a fall-prevention intervention. According to a review, there is insufficient evidence to create nutritional guidelines specific for frail older adults with type 2 diabetes. There is a need to motivate and empower older adults with type 2 diabetes to make lifestyle changes to prevent frailty. The purpose of this review was to identify and integrate what is known and what still needs to be done for this population to be successful in making health behavior changes to reduce frailty. There is some evidence that motivational approaches have worked for older adults with various chronic disease conditions. However, studies applying motivational strategies are lacking for frail older adults with type 2 diabetes. A novel motivational approach was described; it combines aspects of the Health Belief Model and Motivational Interviewing. Intervention studies incorporating this model are needed to determine whether this client-driven strategy can help various racial/ethnic populations make the sustainable health behavior changes of increasing exercise and healthy eating while taking into consideration physiological, psychological, and economic barriers.

scholarly journals The Influence of Family History of Type 2 Diabetes Mellitus on Positive Health Behavior Changes among African Americans

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Donny Ard ◽  
Naa-Solo Tettey ◽  
Shinga Feresu
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Family History ◽  
Health Behavior ◽  
Behavior Changes ◽  
Positive Health ◽  
History Of ◽  
Health Behavior Changes

Type 2 diabetes mellitus (T2DM) is a disease that affects the body’s ability to metabolize glucose effectively. The disease is predicted to be prevalent in over 300 million people by the year 2030. African Americans (AA) have the highest prevalence rates of type 2 diabetes mellitus (T2DM) in the United States. Lifestyle modification and awareness of risk factors, including family history, are important aspects for prevention of developing T2DM. The purpose of this study was to understand if a family history of T2DM played an influential role in individuals making positive health behavior changes for T2DM prevention. The phenomenological study was grounded in the health belief model and also identified barriers associated with inactivity towards positive health behavior changes. Participants selected for this study were at least 18 years of age, self-identified as AA, self-reported a family history of T2DM, and were not diagnosed with the disease themselves. Transcriptions of twenty face-to-face interviews were analyzed via qualitative research software NVivo Version 12 for Mac. Participants demonstrated a strong awareness of T2DM with an accurate definition of T2DM and explanation of signs, symptoms, and prevention. Participants recognized family history as a risk factor in only 55% of the responses. However, family history played a major role in prevention in the lives of the participants. The participants reflected on personal barriers to health behavior changes and were encouraged to incorporate better life choices in their own lives. This research offers communities, healthcare providers, and stakeholders a better understanding of the importance of family history as a risk factor to T2DM as programs are developed to mitigate health disparities in the AA community.

Mental health comorbidity and youth onset type 2 diabetes: A systematic review of the literature

2022 ◽  
pp. 009121742110673
Author(s):  
Molly McVoy ◽  
Heather Hardin ◽  
Erin Fulchiero ◽  
Kate Caforio ◽  
Farren Briggs ◽  
...  
Keyword(s):  
Mental Health ◽  
Type 2 Diabetes ◽  
Depressive Symptoms ◽  
Treatment Options ◽  
Study Data ◽  
Behavior Changes ◽  
Previous Diagnosis ◽  
Health Behavior Changes ◽  
The Impact

Background Type 2 diabetes (T2D) is a burgeoning epidemic in children and adolescents. Adult T2D doubles the risk of depression and mental health comorbidity makes it more difficult to make the lifestyle, medication adherence and health behavior changes needed to optimize outcomes. There is limited research on the impact of depression and depressive symptoms on youth T2D. Methods A search of the literature in the last 10 years regarding youth with depression and T2D was conducted. Abstracts were screened by 2 randomly assigned authors for inclusion, and disagreement was resolved by a third author. Selected full-text articles were divided among all authors for review. Results 13 publications from 8 studies (N=2244, age 6–17) were included. 6 of 13 publications utilized Treatment Options for Type 2 Diabetes in Youth (TODAY) study data. While studies included evaluation of depressive symptoms, most did not formally assess for major depressive disorder (MDD) and excluded participants with a previous diagnosis of MDD. Depressive symptoms were common in this population and were associated with negative T2D outcomes. Conclusions While there is a growing body of adult literature highlighting the extensive relationship between T2D and mental health, there is a dearth of data in youth. Future studies are needed that include, 1.) youth with diagnosed MDD, 2.) treatment studies of both T2D and MDD, 3.) larger, more racially diverse samples of youth with T2D, and 4.) studies that evaluate the impact of social determinants of health, including mental health comorbidity on outcomes of T2D.

scholarly journals Self-Efficacy of Exercise in Older Adults with Diabetes: A Concept Analysis

Jurnal NERS ◽  
2020 ◽  
Vol 15 (1) ◽  
pp. 105
Author(s):  
Somsak Thojampa ◽  
Chawapon Sarnkhaowkhom ◽  
Sirikanok Khankhajhon ◽  
Roongtiva Boonpracom ◽  
Amaraporn Puraya ◽  
...  
Keyword(s):  
Older Adults ◽  
Health Behavior ◽  
Self Efficacy ◽  
Healthcare Professionals ◽  
Specific Activity ◽  
Concept Analysis ◽  
Clinical Usefulness ◽  
Behavior Changes ◽  
Thai People ◽  
Health Behavior Changes

Introduction: Self-efficacy is defined as a person’s own judgment of their capabilities to perform a specific activity to attain a particular outcome. The concept of self-efficacy of exercise in older adults with diabetes may still be unclear, so it is essential to elucidate its meaning for better understanding in this concept. This paper aims to explore the meaning of self-efficacy with regard to exercise in older adults with diabetes.Methods: Using the Walker and Avant concept analysis, it discusses cases showing diabetic Thai people and how they manage their health behavior changes, such as with exercise.Results: Analysis of the concept of self-efficacy in terms of its defining attributes, antecedents, consequences, and empirical referents provides information related to clinical usefulness. It helps healthcare professionals communicate the same notion when discussing self-efficacy and can distinguish this concept from other related concepts.Conclusion: Analysis of the concept of self-efficacy provides information related to exercise in older adults and can assist healthcare professionals in communicating the same notion when discussing the concept. 

scholarly journals Sociodemographic and clinical functional factors in pre-frail and frail older adults with type 2 Diabetes Mellitus in relation to low levels of physical activity

2020 ◽  
Vol 23 (1) ◽  
Author(s):  
Ana Clara Teixeira Fernandes ◽  
Bartolomeu Fagundes de Lima Filho ◽  
Íkaro Felipe da Silva Patrício ◽  
Vanessa da Nóbrega Dias ◽  
Fabrícia Azevêdo da Costa Cavalcanti ◽  
...  
Keyword(s):  
Physical Activity ◽  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Older Adults ◽  
Type 2 Diabetes Mellitus ◽  
Frail Older Adults ◽  
Functional Factors ◽  
Low Levels ◽  
Years Of Schooling

Abstract Objective: To determine the sociodemographic and clinical-functional factors related to low levels of physical activity in pre-frail and frail older adults with type 2 diabetes mellitus (DM2). Method: an observational, analytical, cross-sectional study was performed. The sample consisted of older adults aged 60 years or over with a clinical diagnosis of DM2 who were treated at the Onofre Lopes University Hospital (or HUOL). Sociodemographic and clinical-functional data were evaluated with the following instruments: the Timed Up and Go (TUG) test, the Mini Mental State Examination (MMSE), the 15-item Geriatric Depression Scale (GDS), the International Physical Activity Questionnaire (IPAQ) and the frailty phenotype. The Chi-square and Mann Whitney tests were used for data analysis. Results: the study sample consisted of 113 individuals classified as pre-frail (52.2%) and frail (47.8%). Low levels of physical activity were verified in 79.6% of the sample. The most closely related variables that showed a statistically significant difference with low levels of physical activity were: years of schooling (p=0.02), social participation (p=0.005), insulin therapy (p=0.02), pain in the lower limbs (p=0.03) and depressive symptoms (p=0.04). Also, significant differences were found between low levels of physical activity and age (p=0.04) and years of schooling (p=0.05). Conclusions: Low levels of physical activity are associated with certain sociodemographic and clinical-functional factors, some of which are modifiable. Identifying these is important for the development of appropriate health interventions for the prevention and treatment of both DM2 and the Frailty Syndrome (FS).

scholarly journals Prospective Monitoring of Newly Marketed Drugs in Frail Older Adults Using Real-World Databases

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 209-209
Author(s):  
Dae Kim ◽  
Elisabetta Patorno
Keyword(s):  
Heart Failure ◽  
Type 2 Diabetes ◽  
Older Adults ◽  
Real World ◽  
New Drugs ◽  
Frail Older Adults ◽  
Drug Benefits ◽  
Monitoring Framework ◽  
Prospective Monitoring

Abstract In recent years several new drugs have been approved for treatment of heart failure and type 2 diabetes. Despite their life-prolonging benefits, uptake of new drugs is often slow among older patients with frailty due to under-representation of frail older adults in pivotal clinical trials and concerns for adverse events. To optimize pharmacotherapy, timely evaluation of the drug benefits and risks is urgently needed. We propose a novel drug monitoring framework that prospectively evaluates the effectiveness and safety of newly marketed drugs for frail and non-frail patients in real-world databases. This framework utilizes a validated claims-based frailty index (CFI) (range: 0-1; frail if ≥0.20) to find early signals for effectiveness and safety of new drugs by updating the analysis at regular intervals as new data become available. In this symposium, we present early results of this prospective monitoring framework for 2 new drug classes using Medicare claims data from the approval date until the end of 2017: 1) angiotensin receptor-neprilysin inhibitor (ARNI) (approved in July 2015) for heart failure with reduced ejection fraction (HFrEF) and 2) sodium-glucose cotransporter-2 inhibitors (SGLT2i) (approved in March 2013) for type 2 diabetes. We first show the uptake of ARNI and SGLT2i over time among the eligible Medicare beneficiaries by clinical characteristics, including frailty. Subsequently we present the results of sequential cohort analysis for the effectiveness and safety results of ARNI and SGLT2i. After these presentations, the panel will discuss the strengths, limitations, and challenges of implementing our monitoring framework in real-world databases.

Spousal Support and Food-Related Behavior Change in Middle-Aged and Older Adults Living With Type 2 Diabetes

2006 ◽  
Vol 35 (5) ◽  
pp. 707-720 ◽  
Author(s):  
Elizabeth A. Beverly ◽  
Carla K. Miller ◽  
Linda A. Wray
Keyword(s):  
Type 2 Diabetes ◽  
Older Adults ◽  
Social Cognitive Theory ◽  
Social Cognitive ◽  
Cognitive Theory ◽  
Spousal Support ◽  
Behavior Changes ◽  
Middle Aged ◽  
Spousal Relationship

One of the most challenging diabetes-related behavior changes is adhering to a healthful diet. Drawing on the social cognitive theory and social support literature, this qualitative study explores how spousal support influences dietary changes following a diagnosis of type 2 diabetes in middle-aged and older adults. The purpose of this study was to determine how aspects of the spousal relationship translate into behavior changes, specifically adherence to a healthful diet. Analyses revealed five core themes related to dietary adherence: control over food, dietary competence, commitment to support, spousal communication, and coping with diabetes. The themes can be categorized within two key social cognitive theory constructs: reinforcement and self-efficacy. Implications from the focus group data can inform the development of more effective, targeted nutrition messages and programs to provide specific knowledge and skills.

scholarly journals Diabetes Diagnosis, Social Support, and Health Behavior Changes in Older Adults

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 108-108
Author(s):  
Weidi Qin
Keyword(s):  
Physical Activity ◽  
Social Support ◽  
Older Adults ◽  
Alcohol Consumption ◽  
Health Behavior ◽  
Behavior Changes ◽  
Diabetes Diagnosis ◽  
Health Promoting Behaviors ◽  
Health Promoting ◽  
Health Behavior Changes

Abstract The growing disease burden of diabetes in older adults highlights the importance of health-promoting behaviors in this population. A new diagnosis of diabetes can be a teachable moment that motivates older adults to engage in health behavior changes. Guided by the convoy model of social relations, social support from family and friends may influence health behaviors, and moderate the effects of a diabetes diagnosis on health behaviors. The current study investigates health behavior changes in drinking, smoking, and physical activity before and after a diabetes diagnosis, and whether social support moderates the relationships. A sample of 13,143 older adults without diabetes at baseline were selected from the Health and Retirement Study, and followed up for six waves. Social support from family and friends were measured separately. Mixed-effects regression models were performed. Sampling weights were adjusted to generate population estimates. After a diabetes diagnosis, older adults reduced alcohol consumption and were more likely to quit smoking. More social support from family was associated with decreased alcohol consumption, and more social support from friends was associated with increased physical activity. Significant interaction between social support from family and diabetes diagnosis was found. Specifically, among older adults with a diabetes diagnosis, more social support from family was associated with less drinking and smoking cessation. The study findings suggest that health practitioners can consider the timing of diabetes diagnosis to facilitate health behavior changes. Furthermore, diabetes educators can help older adults mobilize support from family and friends to better engage in health-promoting behaviors.

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