Date of Award

3-25-2018

Publication Type

Doctoral Thesis

Degree Name

Ph.D.

Department

Psychology

Keywords

Cognitive Functioning, Diabetes, Diabetes Self-Management, Quality of Life, Self-Care

Supervisor

Dennis Jackson

Rights

info:eu-repo/semantics/openAccess

Abstract

The present investigation comprised exploratory prospective and retrospective studies of the relationships between cognitive functioning, Diabetes Self-Management Behaviour (DSMB) completion, and diabetes-related and general Quality of Life (QoL). A prospective study explored the relationships among these variables in a sample of 26 adults over the age of 40 with Type 2 Diabetes Mellitus (T2DM). Measures used included validated neuropsychological tests assessing multiple cognitive domains and abilities, three self-report measures of DSMB, and the Audit of Diabetes Dependent Quality of Life (ADDQoL). Increased performance on a phonemic verbal fluency task was significantly related to better DSMB behaviour completion (r = .577, p = .002, r2 = .333). There were many significant relationships between a self-report measure of executive functioning and DSMB completion. Processing speed and objective and self-report measures of executive functioning correlated significantly with general QoL. An archival study investigated these relationships using data from the Health and Retirement Study (HRS). The Telephone Interview for Cognitive Status (TICS) assessed cognitive functioning, and measures of DSMB completion and impact of diabetes on life from the 2003 HRS diabetes survey were used to assess DSMB completion and QoL outcome variables in a sample of 776 community dwelling adults with T2DM. Cognitive functioning as measured by the TICS did not account for significantly more variance and did not significantly predict DSMB completion over and above demographic and health-related variables for any of the domains of DSMB completion. Cognitive functioning and a total score of difficulty with DSMB completion accounted for significantly more variance in diabetes impact over and above demographic and health-related variables when A1C was (F(2, 503) = 9.846, p < .001) and was not (F(2, 700) = 13.282, p < .001) included in the model. However, cognitive functioning was not a significant predictor of diabetes impact in either model. Difficulty with DSMB completion was a significant predictor in both models and thus accounted for most of the increase in variance explained above and beyond that explained by the demographic and health-related variables. The implications of the results for future studies of the relationships between cognitive functioning, DSMB completion, and QoL are discussed, as well as the strengths and limitations of the prospective and archival studies.

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