Relationship of self-efficacy and physical activity with cognitive level in older adults with type 2 diabetes

Year 2024, Volume: 49 Issue: 4, 935 - 946, 30.12.2024

Büşra Duran , Alime Selçuk Tosun

https://doi.org/10.17826/cumj.1437245

Abstract

Purpose: This study was conducted to determine the mental, self-efficacy, and physical activity levels of older adults with type 2 diabetes mellitus and examine the factors affecting the cognitive level.
Materials and Methods: This descriptive correlational study was designed with a sample of 170 older adults. Data were collected using a personal information form, the Standardized Mini-Mental Test (SMMT), the Type 2 Diabetes Self-Efficacy Scale, and the Physical Activity Scale for the Elderly (PASE).
Results: The mean cognitive level score of the participants was 22.99 ± 5.36. It was found that the total physical activity score, total self-efficacy score, and the self-efficacy sub-dimensions of diet and diabetic foot control, medical treatment, and physical exercise explained 84.9% of the variance in cognitive level (Adjusted R² = 0.849). A statistically significant difference was found in total physical activity, total self-efficacy, and the self-efficacy sub-dimensions of diet and diabetic foot control, medical treatment, and physical exercise between older adults with and without cognitive impairment. These influential factors were found to explain 89.2% of the variance in cognitive level.
Conclusion: Total physical activity, overall self-efficacy, and self-efficacy sub-dimension scores were found to influence the cognitive levels of older adults. Thus, risk groups can be identified among elderly individuals with Type 2 DM regarding cognitive levels, allowing for targeted monitoring of these individuals. The results of this study may offer valuable insights for planning interventions aimed at enhancing self-efficacy and physical activity, both of which are associated with cognitive levels.

Keywords

Self-efficacy, Type 2 diabetes mellitus, Physical activity, Older adults, Cognitive level

Tip 2 diyabeti olan yaşlı bireylerde bilişssel düzeyin öz-etkililik ve fiziksel aktivite ile ilişkisi

Abstract

Amaç: Bu çalışma tip 2 diyabetli yaşlı bireylerin bilişsel, öz-yeterlik ve fiziksel aktivite düzeylerini belirlemek ve bilişsel düzeyi etkileyen faktörleri incelemek amacıyla yapılmıştır.
Gereç ve Yöntem: Bu tanımlayıcı korelasyonel çalışma, 170 yaşlı yetişkinden oluşan bir örneklemle tasarlanmıştır. Araştırma verilerinin toplanmasında kişisel bilgi formu, Standardize Mini Mental Test (SMMT), Tip 2 Diyabet Öz-Etkililik Ölçeği, Yaşlılar İçin Fiziksel Aktivite Ölçeği (PASE) kullanılmıştır.
Bulgular: Katılımcıların ortalama bilişsel düzey puanı 22,99 ± 5,36 idi. Fiziksel aktivite toplam puanı, öz yeterlilik toplam puanı, diyet ve diyabetik ayak kontrolü, tıbbi tedavi ve öz yeterliliğin fiziksel egzersiz alt boyutunun varyansın %84,9'unu (Düzeltilmiş R2= 0,849) açıkladığı belirlendi. bilişsel düzey. Bilişsel bozukluğu olan ve olmayan yaşlı yetişkinler arasında öz yeterliliğin toplam fiziksel aktivite, toplam öz-yeterlik, diyet ve diyabetik ayak kontrolü, tıbbi tedavi ve fiziksel egzersiz alt boyutları açısından istatistiksel olarak anlamlı farklılık bulunmuştur. Bilişsel bozukluğu olan ve olmayan yaşlı bireylerin fiziksel aktivite toplam, öz-etkililik toplam,diyet+ayak kontrolü, tıbbi (medikal) tedavi ve fiziksel egzersiz öz-etkililik alt boyutu arasında istatistiksel olarak anlamlı fark olduğu bulunmuştur (
Sonuç: Toplam fiziksel aktivite, genel öz-yeterlik ve öz-yeterlik alt boyut puanlarının yaşlı yetişkinlerin bilişsel düzeylerini etkilediği bulunmuştur. Böylece Tip 2 DM'li yaşlı bireylerde bilişsel düzeyler açısından risk grupları belirlenerek bu bireylerin hedefe yönelik takibi sağlanabilecektir. Bu çalışmanın sonuçları, her ikisi de bilişsel düzeylerle ilişkili olan öz yeterliliği ve fiziksel aktiviteyi artırmayı amaçlayan müdahalelerin planlanması için değerli bilgiler sunabilir.

Keywords

Öz yeterlilik, tip 2 diyabet, fiziksel aktivite, yaşli yetişkinler, bilişsel düzey, hemşirelik

References

• International Diabetes Federation (IDF). Diabetes Atlas Ninth Edition. Brussels, International Diabetes Federation, 2019.
• Davies MJ, D'Alessio DA, Fradkin J, Kernan WN, Mathieu C, Mingrone G et al. Management of hyperglycemia in type 2 diabetes. Diabetes Care. 2018;41:2669-701.
• Palacios-Mendoza M, Jurado MB, Gamboa X, Cevallos C, Moreno-Zambrano D, Duarte MC et al. Diabetes is associated with cognitive decline in middle-aged patients. Metab Syndr Relat Disord. 2018;16:514-20.
• Crane PK, Walker R, Hubbard RA, Li G, Nathan DM, Zheng H et al. Glucose levels and risk of dementia. N Engl J Med. 2013;369:540-8.
• Ravona R, Heymann A, Lin HM, Liu X, Berman Y, Schwartz J et al. The increase in number of depression symptoms over time is related to worse cognitive outcomes in older adults with type 2 diabetes. Am J Geriatr Psychiatr. 2021;29:1-11.
• Bandura A. Self-Efficacy: The Exercise of Control. New York, Macmillan, 1997.
• Świątoniowska-Lonc N, Polański J, Tański W, Jankowska-Polańska B. Impact of cognitive impairment on adherence to treatment and self-care in patients with type 2 diabetes mellitus. Diabetes Metab Syndr Obes. 2021;14:193-203.
• Rokicka D, Wróbel M, Szymborska-Kajanek A, Bożek A, Strojek K. Assessment of compliance to self-monitoring of blood glucose in type 2 diabetic patients and level of implementation of Polish Diabetes Association Recommendation for general practitioners. Clin Diabetol J. 2018;7:129-35.
• Al-Khawaldeh OA, Al-Hassan MA, Froelicher ES. Self-efficacy, self-management, and glycemic control in adults with type 2 diabetes mellitus. J Diabetes Complications. 2012;26:10-6.
• Li P, Guo J. Research progress on the self-efficacy level of patients with type 2 diabetes mellitus and its influencing factors. Open J Prev Med. 2024;14:79-89.
• Callisaya M, Nosaka K. Effects of exercise on type 2 diabetes mellitus-related cognitive impairment and dementia. J Alzheimers Dis. 2017;59:503-13.
• Reas ET, Laughlin GA, Bergstrom J, Kritz-Silverstein D, McEvoy L. Physical activity and trajectories of cognitive change in community-dwelling older adults: The Rancho Bernardo Study. J Alzheimers Dis. 2019;71:109-18.
• Chen L, Cao Q. Poverty increases the risk of incident cognitive impairent among older adults: a longitudinal study in China. Aging Ment Health. 2020;24:1822-27.
• Randhawa SS, Varghese D. Geriatric evaluation and treatment of age-related cognitive decline. In StatPearls. Treasure Island (FL), StatPearls Publishing, 2024.
• Petersen RC. Mild cognitive impairment. Continuum. 2016;22:404-18.
• Uijen IL, Aaronson JA, Karssemeijer EG, Rikkert MG, Kessels RP. Individual differences in the effects of physical activity on cognitive function in people with mild to moderate dementia. J Alzheimers Dis. 2020;74:435-39.
• Cohen J, Cohen P, West SG, Aiken LS. Applied Multiple Regression Correlation Analysis for the Behavioral Sciences. New York, Routledge, 1985.
• Folstein MF, Folstein SE, McHugh PR. Mini-mental state: A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975;12:189-98.
• Güngen C, Ertan T, Eker E, Yaşar R, Engin F. Reliability and validity of the standardized mini mental state examination in the diagnosis of mild dementia in Turkish population. Turk Psikiyatri Derg. 2002;13:273-81.
• Washburn RA, McAuley E, Katula J, Mihalko SL, Boileau RA. The physical activity scale for the elderly (PASE): evidence for validity. J Clin Epidemiol. 1999;52:643-51.
• Ayvat E, Kilinç M, Kirdi N.The Turkish version of the Physical Activity Scale for the Elderly (PASE): its cultural adaptation, validation, and reliability. Turk J Med Sci. 2017;47:908-15.
• Van Der. Bijl, JV, Poelgeest-Eeltink AV, Shortridge-Baggett L. The psychometric properties of the diabetes management self-efficacy scale for patients with type 2 diabetes mellitus. J Adv Nurs. 1999;30:352-59.
• Kara M, Van JJ, Shortridge-Baggett LM, Asti T, Erguney S. Cross-cultural adaptation of the diabetes management self-efficacy scale for patients with type 2 diabetes mellitus: scale development. Int J Nurs Stud. 2006;43:611-21.
• Swinscow TV, Campbell MJ. Statistics at Square One. 10rd Edition. London, Wiley, 2002.
• Ciudin A, Espinosa A, Simó-Servat O, Ruiz A, Alegret M, Hernandez C et al. Type 2 diabetes is an independent risk factor for dementia conversion in patients with mild cognitive impairment. J Diabetes Complications. 2017;31:1272-74.
• Yerrapragada DB, Rao CR, Karunakaran K, Lee HE. Cognitive dysfunction among adults with type 2 diabetes mellitus in Karnataka, India. Ochsner J. 2019;19:227-34.
• Gomes LC, Coelho AM, Gomides DS, Foss-Freitas MC, Foss MC, Pace AE. Contribution of family social support to the metabolic control of people with diabetes mellitus: A randomized controlled clinical trial. Appl Nurs Res. 2017;36:68-76.
• Gatlin PK, Insel KC.Severity of type 2 diabetes, cognitive function, and self-care. Biol Res Nurs. 2015;17:540-8.
• Gyasi RM, Phillips DR. Aging and the rising burden of non-communicable diseases in sub-Saharan Africa and other low- and middle-income countries: a call for holistic action. Gerontologist. 2020;60:806-11.
• Shaw BA, Yang TC, Kim S. Living alone during old age and the risk of dementia: assessing the cumulative risk of living alone. J Gerontol B Psychol Sci. Soc Sci. 2023;78:293-301.
• Desai R, John A, Stott J, Charlesworth G. Living alone and risk of dementia: a systematic review and meta-analysis. Ageing Res Rev. 2020;62: 101122..
• Zhong BL, Chen SL, Tu X, Conwell Y. Loneliness and cognitive function in older adults: Findings from the Chinese longitudinal healthy longevity survey. J Gerontol B Psychol Sci Soc Sci. 2017;72:120-8.
• Daimiel L, Martínez-González MA, Corella D, Salas-Salvadó J, Schröder H, Vioque J et al. Physical fitness and physical activity association with cognitive function and quality of life: baseline cross-sectional analysis of the Predimed-Plus trial. Sci Rep. 2020;10:3472.
• Nooyens AC, Baan CA, Spijkerman AM, Verschuren WM. Type 2 diabetes and cognitive decline in middle-aged men and women: the doetinchem cohort study. Diabetes Care. 2010;33:1964-9.
• Sun L, Diao X, Gang X, Lv Y, Zhao X, Yang S et al. Risk factors for cognitive impairment in patients with type 2 diabetes. J Diabetes Res. 2020;2020:4591938..
• Kössler T, Weber KS, Wölwer W, Hoyer A, Strassburger K, Burkart V et al. Associations between cognitive performance and Mediterranean dietary pattern in patients with type 1 or type 2 diabetes mellitus. Nutr Diabetes. 2020;10:10.
• Albai O, Frandes M, Timar R, Roman D, Timar B. Risk factors for developing dementia in type 2 diabetes mellitus patients with mild cognitive impairment. Neuropsychiatr Dis Treat. 2019;15:167-75.
• Spauwen PJ, VanBoxtel MP, Verhey FR, Köhler S, Sep SJ, Koster A et al. Both low and high 24-hour diastolic blood pressure are associated with worse cognitive performance in type 2 diabetes: the Maastricht Study. Diabetes Care. 2015;38:1473-80.
• Montserrat J, Ferdynusi C, Michalon S, Montee N, Koleck M, Serveaux JP et al. Cognitive function and self-efficacy in insufficiently controlled type 2 diabetes patients. Ther Patient Educ. 2015;7:101-3.
• Santos T, Lovell J, Shiell K, Johnson M, Ibrahim J.E. The impact of cognitive impairment in dementia on self-care domains in diabetes: A systematic search and narrative review. Diabetes Metab Res Rev. 2018;34:e3013..
• Bai A, Tao L., Huang J, Tao J, Liu J. Effects of physical activity on cognitive function among patients with diabetes in China: a nationally longitudinal study. BMC Public Health. 2021;21:481.
• Wang R, Yan W, Du M, Tao L, Liu J. The effect of physical activity interventions on cognition function in patients with diabetes: A systematic review and meta‐analysis. Diabetes Metab Res Rev. 2021;37:e3443..
• Baker LD, Frank L, Foster-Schubert K, Green PS, Wilkinson CW, McTiernan A et al. Effects of aerobic exercise on mild cognitive impairment: a controlled trial. Arch Neurol. 2010;67:71-9.