Background: Subjective cognitive decline (SCD; self-perceived decrements in cognitive functioning in spite of objective cognitive performance within the normal range) subtle cognitive decline (subtle CD; objective sub-clinical decrements in cognitive functioning), and APOE 4 genotype have each been identified as potential risk factors for Alzheimer’s and other pathological cognitive decline in later life. However, despite considerable research attention, our accrued knowledge of potential dementia risk factors has failed to coalesce into a reliable screening measure or assessment method at the earliest preclinical stages of decline. A key issue undermining this effort is the challenge of discriminating older adults experiencing age-normative cognitive changes and complaints from those with dementia risk-relevant concerns and experiences. This, in turn, may result from a fractured field that emphasizes some sources of information (e.g., cognitive test performance) at the expense of others entirely (e.g., self-reported experiences). In light of this, a mixed-methods approach integrating the various methods of enquiry and sources of data may be appropriate at this juncture. Sample and data collection: n=65 healthy community-dwelling older adults from Victoria, BC, Canada completed a brief neuropsychological assessment, participated in interviews related to their first-hand experiences of aging and cognitive change, and provided saliva samples for the purposes of genotype analysis. Chapter 1: This chapter presents a systematic review authored by the Principal Investigator and several Supervisory Committee Members prior to the commencement of this dissertation. This paper presents the current evidence regarding the relationship between SCD and APOE 4 genotype. It is included in this dissertation to contextualize our analysis and overall findings. Chapter 2: This chapter provides an overview of the methods and materials used for the subsequent dissertation studies. Chapter 3: The objective of this investigation was to identify specific psychosocial and demographic predictors of SCD and subtle CD and, by extension, to determine whether these two variables may reflect similar underlying factors. Our findings determined that the predictors for SCD and subtle CD were entirely separable. Moreover, SCD and subtle CD were not found to be related. Chapter 4: This study explored which commonly endorsed qualitative experiences correspond with SCD and subtle CD. Commonly endorsed qualitative experiences were categorized according to commonality and clinical convention. MANOVA and Mann-Whitney U analyses were performed to determine the association of SCD and subtle CD with categories of experience controlling for other demographic and psychosocial factors. Executive functioning declines and related compensatory strategies were strongly associated with both SCD and subtle CD – challenging the traditionally memory-centric focus of the majority of dementia risk research. Conclusions: As a first step, this work provides evidence that SCD may not relate to early sub-clinical objective cognitive declines. Further, executive functioning – and not episodic memory – may be a key area to explore when determining early risk-predicting cognitive declines. Overall, this work presents the potential utility of more qualitatively-oriented research to inform the development of comprehensive and multimodal risk assessment approaches. Caveats, limitations, clinical implications, and future directions are discussed. / Graduate / 2021-07-31

Bakgrund: Fem procent av alla barn beräknas ha den neuropsykiatriska diagnosen adhd. Jämfört med barn generellt har de större utmaningar i livet. Kompensatoriska åtgärder för barnets kognitiva svårigheter genom kognitivt stöd rekommenderas för att minska utmaningarna i barnets aktivitetsutförande. Forskning visar på positiva effekter av insats i form av kognitivt stöd men området behöver beforskas mer. Syfte: Syftet med studien var att kartlägga föräldrars syn på hur arbetsterapeutisk individuell insats i form av kognitivt stöd till barn med adhd-diagnos i åldern 6–12 år påverkat deras föräldrastrategier. Metod: Studien genomfördes med kvantitativ deskriptiv design i form av tvärsnittsstudie, genom trettio enkäter, till föräldrar i slutfasen av insatsen. Resultat: Kognitivt stöd ledde enligt föräldrarna till förbättrade föräldrastrategier inom olika områden som hjälpte barnen både att klara vardagliga aktiviteter bättre och hantera svårigheter avseende känslor. Föräldrarna skattade även att föräldrastrategierna stärkte föräldra-barnrelationen och ledde till minskade problematiska känsloreaktioner hos barnet. Slutsats: Studiens resultat indikerar att arbetsterapeutisk individuell insats i form av kognitivt stöd till barn med adhd kan innebära förbättrade föräldrastrategier inom olika områden som kan påverka barnets aktivitetsutförande, förbättra föräldra-/barnrelationen och minska problematiska känsloreaktioner hos barnet.

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No description available.

No / The 5-HT1A receptor has been extensively studied over the last two decades. There is a plethora of information describing its anatomical, physiological and biochemical roles in the brain. In addition, the development of selective pharmacological tools coupled with our understanding of psychiatric pathology has lead to multiple hypotheses for the therapeutic utility of 5- and in particular 5-HT1A receptor antagonists. Over the last decade it has been suggested that 5-HT1A receptor antagonists may have therapeutic utility in such diseases as depression, anxiety, drug and nicotine withdrawal as well as schizophrenia. However, a very compelling rationale has been developed for the therapeutic potential of 5-HT1A receptor antagonists in Alzheimer s disease and potentially other diseases with associated cognitive dysfunction. Receptor blockade by a 5-HT1A receptor antagonist appears to enhance activation and signaling through heterosynaptic neuronal circuits known to be involved in cognitive processes and, as such, represents a novel therapeutic approach to the treatment of cognitive deficits associated with Alzheimer s disease and potentially other disorders with underlying cognitive dysfunction.

INTRODUÇÃO: A Mini-Addenbrooke\'s Cognitive Examination (M-ACE) consiste em um teste de avaliação cognitiva breve composta de cinco itens que visam avaliar quatro domínios cognitivos principais (orientação, memória, linguagem e função viso-espacial) com pontuação máxima de 30 pontos e um tempo de administração de cinco minutos. OBJETIVO: Avaliar o desempenho de idosos cognitivamente saudáveis, com CCL e DA leve na versão brasileira da M-ACE. MÉTODOS: o teste foi aplicado um grupo de 23 pacientes com DA provável leve, 36 CCL e 25 idosos cognitivamente saudáveis. Todos os participantes incluídos tinham idade >= 60 anos. Foram excluídos pacientes com demência de intensidade moderada ou grave, demência de outra etiologia, comorbidades graves com potencial de comprometer a cognição e uso de medicação psicotrópica. A acurácia do teste foi avaliada por meio da análise das curvas ROC. Para analisar a relação entre os escores da M-ACE e os demais testes cognitivos aplicados foram utilizados os coeficientes de correlação de Spearman. Para analisar a consistência interna da M-ACE e suas três versões foi utilizado o coeficiente alfa de Cronbach. RESULTADOS: Houve um predomínio do gênero feminino, a média de idade foi de 73 anos, com faixa etária predominante de 60-69 anos. A média de escolaridade obtida foi de 11 anos. A M-ACE apresentou alta consistência interna (alfa de Cronbach > 0,8; IC 95% 0,776 a 0,869) e mostrou ser extremamente capaz de diferenciar o grupo DA dos demais participantes, com uma acurácia superior ao MEEM. O ponto de corte de 20 foi o de maior sensibilidade e especificidade (95,6% e 90,16% respectivamente), com área sob a curva considerada alta (ASC = 0,805; IC 95% 0,705 -0,904). A M-ACE apresentou melhor precisão em diferenciar os três grupos quando comparado com o MEEM (71,43 versus 60,71). Observou-se ainda uma precisão mais robusta em diferenciar DA de CCL com a M-ACE (63,89 versus 30,56 no MEEM). O escore total da M-ACE não sofreu considerável influência da idade e escolaridade. A M-ACE apresentou forte correlação com MEEM (cor = 0,78), bem como todos os itens (exceto percepção) da BBRC e QAF (cor = -0,76). CONCLUSÃO: A M-ACE pode ser considerada um teste rápido de rastreio com elevada acurácia no diagnóstico de DA. O ponto de corte sugerido neste estudo é de 20 para DA e 27 para CCL / INTRODUCTION: The Mini-Addenbrooke\'s Cognitive Examination (M-ACE) consists of a brief cognitive assessment test composed of five items that aim to evaluate four main cognitive domains (orientation, memory, language and visuospatial function) with a maximum score of 30 points and a time of administration of five minutes. OBJECTIVE: Evaluate the performance of cognitively healthy elderly, MCI and mild AD in the Brazilian version of M-ACE. METHODS: The test was applied to a group of 23 patients with mild probable AD, 36 MCI and 25 cognitively healthy elderly. All included participants were aged >= 60 years. Patients with moderate or severe dementia, dementia of another etiology, severe comorbidities with potential to compromise cognition and use of psychotropic medication were excluded. The accuracy of the test was evaluated by analyzing the ROC curves. Spearman\'s correlation coefficients were used to analyze the relationship between the M-ACE scores and the other cognitive tests applied. In order to analyze the internal consistency of the M-ACE, the Cronbach\'s alpha coefficient was used. RESULTS: There was a predominance of females, mean age was 73 years, with a predominant age range of 60-69 years. The average level of schooling was 11 years. MACE presented high internal consistency (Cronbach\'s alpha > 0.8, 95% CI 0.776 to 0.869) and showed to be extremely capable of differentiating the AD group from the other participants, with a higher accuracy than the MMSE. The cutoff point of 20 was the one with the highest sensitivity and specificity (95.6% and 90.16%, respectively), with an AUC considered to be high (AUC = 0.805, 95% CI 0.705-0.904). The M-ACE presented better accuracy in differentiating the three groups when compared to the MMSE (71.43 versus 60.71). It was also observed a more robust precision in differentiating DA of MCI with M-ACE (63.89 versus 30.56 in MMSE). The total M-ACE score was not very influenced by age and schooling. M-ACE showed a strong correlation with MMSE (spearman = 0.78), as well as all items (except perception) of BBRC and QAF (spearman = -0.76). CONCLUSIONS: M-ACE can be considered a brief screening tool with high accuracy in the diagnosis of AD. The cutoff point suggested in this study is 20 for AD and 27 for MCI

Submitted by Sara Ribeiro (sara.ribeiro@ucb.br) on 2018-09-14T21:40:04Z No. of bitstreams: 1 AlyneMatosNapoleaoFariasDissertacao2018.pdf: 1451305 bytes, checksum: 3527c8590821219daf2aad10bf27a157 (MD5) / Approved for entry into archive by Sara Ribeiro (sara.ribeiro@ucb.br) on 2018-09-14T21:40:19Z (GMT) No. of bitstreams: 1 AlyneMatosNapoleaoFariasDissertacao2018.pdf: 1451305 bytes, checksum: 3527c8590821219daf2aad10bf27a157 (MD5) / Made available in DSpace on 2018-09-14T21:40:19Z (GMT). No. of bitstreams: 1 AlyneMatosNapoleaoFariasDissertacao2018.pdf: 1451305 bytes, checksum: 3527c8590821219daf2aad10bf27a157 (MD5) Previous issue date: 2018-07-05 / In Brazil the number of elderly people is increasing and this transformation in the age structure is taking place without an improvement of the living conditions. With increased life expectancy there is a greater probability of chronic and degenerative diseases, such as Mild Cognitive Disorder (MCD). The use of cognitive stimuli through cognitive stimulation therapies (CST) causes them to regress and / or interfere with advancement. The objective was to analyze changes in cognitive profile, with emphasis on memory, before and after the execution of cognitive stimulation workshops, as well as to identify socioeconomic characteristics of sedentary elderly people who attend the Mixed Health Unit of Taguatinga, Federal District (UMS-DF). It was a descriptive experimental quantitative study, with elderly (≥60 years), diagnosed with MCD. The composite sample of 9 elderly of the OEC in the experimental group (G1) and 10 elderly did not undergo intervention in the control group (G2). The data collection was done by structured interview, application in the first and last meeting of the mini mental state examination, verbal fluency, clock, memory of figures and list of words. The CST offered to the G1, stimulation techniques were used, for one hour, weekly, in 10 meetings. In G2, daily life activities were reported for the same period, without cognitive stimulation. The descriptive data were evaluated by means of descriptive measures: means, standard deviations, median, absolute and relative frequency, with p <= 0,05. The chi-square test and t-test were applied using the SPSS 20.0 program and the R. software. Results showed mean age of 75 ± years, 84.2% female, 89.5% retired and 89.5% widowed. 17 elderly (89.5%) reported better memory a year ago. After CST, 8 (88.9%) elderly of the G1 considered their current memory as good. Although the G1 elderly had higher scores in all tests after the CST, the difference between the tests was not significant (p = 1.0). No significant differences were found in the Miniexame of the Mental State (p = 0.436). The test of the clock design evidenced the low level of schooling. G1 (p> 1) and G2 (p = 0.621), the tests were not statistically significant, affirming no or almost no change in the cognitive profile. In the tests of verbal fluency (p = 0.367), word memory and figures (p = 0.351), G2 showed no recovery in recall, despite reporting an increase in group sociability. It was concluded that although the CST do not have significant results, they have a visible effect on social integration, exchange of experiences and personal empowerment. This method can help nursing to design more effective methods and implementations for the treatment and rehabilitation of not only elderly people with MCD, but with different cognitive conditions. Perhaps longer-term studies can improve such outcomes and encompass the positive aspects of physical activity in the cognitive area. / No Brasil, é crescente o número de idosos e essa transformação na estrutura etária dá-se sem que haja um melhoramento das condições de vida. Com o aumento da expectativa de vida, há maior probabilidade de doenças crônicas e degenerativas, como o Transtorno Cognitivo Leve (TCL). A utilização de estímulos cognitivos, através de oficinas de estimulação cognitiva (OEC), causa seu retrocesso e/ou interfere no avanço. O objetivo foi analisar modificações no perfil cognitivo, com ênfase na memória, antes e após a execução das oficinas de estimulação cognitiva, assim como identificar características socioeconômicas de idosos sedentários que frequentam a Unidade Mista de Saúde de Taguatinga do Distrito Federal (UMST-DF). Foi um estudo quantitativo experimental descritivo, com idosos (≥60 anos), diagnosticados com TCL. A amostra composta de nove idosos das OEC no grupo experimental (G1) e dez idosos que não sofreram intervenção no grupo controle (G2). A coleta de dados foi feita por entrevista estruturada, aplicação no primeiro e último encontro do Miniexame do Estado Mental (MEEM), fluência verbal, relógio, memória de figuras e lista de palavras. As OEC oferecidas ao G1 utilizaram técnicas de estimulação, por uma hora, semanalmente, em dez encontros. No G2, foram feitos relatos das atividades da vida diária, pelo mesmo período, sem estimulação cognitiva. Os dados descritivos foram avaliados pelas medidas descritivas: médias, desvios padrões, mediana, frequência absoluta e relativa, com p<=0,05. Foram aplicados teste de qui-quadrado e teste t pelo programa SPSS 20.0 e software R. Resultados mostraram idade média de 75± anos, 84,2% feminino, 89,5% aposentados e 89,5% viúvos. 17 idosos (89,5%) relataram memória melhor há um ano. Após as OEC, oito (88,9%) idosos do G1 consideraram sua memória atual como boa. Apesar dos idosos do G1 terem pontuações maiores em todos os testes após as OEC, a diferença entre os testes não foram significativas (p= 1,0). No MEEM não surgiu diferença significativa (p=0,436). O teste do desenho do relógio evidenciou o baixo nível de escolaridade: G1 (p>1) e G2 (p= 0,621); os testes não foram significativos, afirmando nenhuma ou quase nenhuma mudança no perfil cognitivo. Nos testes de fluência verbal (p=0,367), de memória de palavras e o de figuras (p=,0,351), o G2 não mostrou recuperação na evocação da memória, apesar de relatar aumento na sociabilidade em grupo. Concluiu-se que, apesar das OEC não terem resultados estatisticamente significativos, possuem efeito visível na integração social, troca de experiências e empoderamento pessoal. Esse método pode auxiliar a enfermagem a traçar métodos e implementações mais eficazes para o tratamento e reabilitação, não só pessoas idosas com TCL, mas com diversas condições cognitivas. Talvez estudos com prazos maiores possam aprimorar tais resultados e abranger os aspectos positivos das atividades físicas na área cognitiva.

INTRODUÇÃO: A Mini-Addenbrooke\'s Cognitive Examination (M-ACE) consiste em um teste de avaliação cognitiva breve composta de cinco itens que visam avaliar quatro domínios cognitivos principais (orientação, memória, linguagem e função viso-espacial) com pontuação máxima de 30 pontos e um tempo de administração de cinco minutos. OBJETIVO: Avaliar o desempenho de idosos cognitivamente saudáveis, com CCL e DA leve na versão brasileira da M-ACE. MÉTODOS: o teste foi aplicado um grupo de 23 pacientes com DA provável leve, 36 CCL e 25 idosos cognitivamente saudáveis. Todos os participantes incluídos tinham idade >= 60 anos. Foram excluídos pacientes com demência de intensidade moderada ou grave, demência de outra etiologia, comorbidades graves com potencial de comprometer a cognição e uso de medicação psicotrópica. A acurácia do teste foi avaliada por meio da análise das curvas ROC. Para analisar a relação entre os escores da M-ACE e os demais testes cognitivos aplicados foram utilizados os coeficientes de correlação de Spearman. Para analisar a consistência interna da M-ACE e suas três versões foi utilizado o coeficiente alfa de Cronbach. RESULTADOS: Houve um predomínio do gênero feminino, a média de idade foi de 73 anos, com faixa etária predominante de 60-69 anos. A média de escolaridade obtida foi de 11 anos. A M-ACE apresentou alta consistência interna (alfa de Cronbach > 0,8; IC 95% 0,776 a 0,869) e mostrou ser extremamente capaz de diferenciar o grupo DA dos demais participantes, com uma acurácia superior ao MEEM. O ponto de corte de 20 foi o de maior sensibilidade e especificidade (95,6% e 90,16% respectivamente), com área sob a curva considerada alta (ASC = 0,805; IC 95% 0,705 -0,904). A M-ACE apresentou melhor precisão em diferenciar os três grupos quando comparado com o MEEM (71,43 versus 60,71). Observou-se ainda uma precisão mais robusta em diferenciar DA de CCL com a M-ACE (63,89 versus 30,56 no MEEM). O escore total da M-ACE não sofreu considerável influência da idade e escolaridade. A M-ACE apresentou forte correlação com MEEM (cor = 0,78), bem como todos os itens (exceto percepção) da BBRC e QAF (cor = -0,76). CONCLUSÃO: A M-ACE pode ser considerada um teste rápido de rastreio com elevada acurácia no diagnóstico de DA. O ponto de corte sugerido neste estudo é de 20 para DA e 27 para CCL / INTRODUCTION: The Mini-Addenbrooke\'s Cognitive Examination (M-ACE) consists of a brief cognitive assessment test composed of five items that aim to evaluate four main cognitive domains (orientation, memory, language and visuospatial function) with a maximum score of 30 points and a time of administration of five minutes. OBJECTIVE: Evaluate the performance of cognitively healthy elderly, MCI and mild AD in the Brazilian version of M-ACE. METHODS: The test was applied to a group of 23 patients with mild probable AD, 36 MCI and 25 cognitively healthy elderly. All included participants were aged >= 60 years. Patients with moderate or severe dementia, dementia of another etiology, severe comorbidities with potential to compromise cognition and use of psychotropic medication were excluded. The accuracy of the test was evaluated by analyzing the ROC curves. Spearman\'s correlation coefficients were used to analyze the relationship between the M-ACE scores and the other cognitive tests applied. In order to analyze the internal consistency of the M-ACE, the Cronbach\'s alpha coefficient was used. RESULTS: There was a predominance of females, mean age was 73 years, with a predominant age range of 60-69 years. The average level of schooling was 11 years. MACE presented high internal consistency (Cronbach\'s alpha > 0.8, 95% CI 0.776 to 0.869) and showed to be extremely capable of differentiating the AD group from the other participants, with a higher accuracy than the MMSE. The cutoff point of 20 was the one with the highest sensitivity and specificity (95.6% and 90.16%, respectively), with an AUC considered to be high (AUC = 0.805, 95% CI 0.705-0.904). The M-ACE presented better accuracy in differentiating the three groups when compared to the MMSE (71.43 versus 60.71). It was also observed a more robust precision in differentiating DA of MCI with M-ACE (63.89 versus 30.56 in MMSE). The total M-ACE score was not very influenced by age and schooling. M-ACE showed a strong correlation with MMSE (spearman = 0.78), as well as all items (except perception) of BBRC and QAF (spearman = -0.76). CONCLUSIONS: M-ACE can be considered a brief screening tool with high accuracy in the diagnosis of AD. The cutoff point suggested in this study is 20 for AD and 27 for MCI

<p> </p><p>Sambandet mellan diabetes och kognitiv dysfunktion har visats i ett flertal studier detsenaste decenniet. Syftet med denna systematiska litteraturstudie var att belysa faktorersom påverkar omvårdnaden av personer med diabetes och kognitiv dysfunktion. Niovetenskapliga artiklar valdes ut i databaserna Cinahl, Clinical Evidence, Cochrane,ELIN@Kristianstad och psycINFO. Dessa kvalitetsbedömdes enligt granskningsmall.Artiklarna analyserades deduktivt enligt Kims domäner personen, omgivningen,yrkesfunktionen och mötet. Fyra huvudfynd identifierades: betydelsen för personen attanpassa sin livssituation och självidentitet, betydelsen av närståendes engagemang ochstöttning, den positiva effekten på den kognitiva förmågan vid regelbunden fysiskaktivitet samt att undervisning bör ske vid korta upprepade sessioner. Somsjuksköterska är det av stor vikt att ha kunskap om sambandet diabetes och kognitivdysfunktion. Beteendeförändringar hos dessa personer bör vara ett observandum somleder till noggrant omvårdnadsstatus. Sjuksköterskan bör i planeringen av omvårdnadoch hjälp till egenvård uppmärksamma både personen och dess närstående. Detframkom i denna litteraturstudie inga kvalitativa artiklar som beskrevegenvårdsstrategier ur ett personcentrerat perspektiv. Önskvärt vore att empiriskastudier kommer till stånd för att belysa detta område.</p> / <p>The relationship between diabetes and cognitive dysfunction has been shown in severalstudies in last decade. The aim of this systematic literature review was to illuminatefactors that affect the nursing care of people with diabetes and cognitive dysfunction.Nine scientific articles were selected form the databases Cinahl, Clinical Evidence,Cochrane, ELIN@Kristianstad and psycINFO. These were assessed according to aquality review template. The articles were analysed deductively according to SuzieKim´s domains of nursing client, client-nurse, environment and practice. Four keyfindingswhere identified: importance for the person to adjust their lives and selfidentity,importance of engagement and support from spouse, the positive effect ofregular physical activity on cognitive ability and that teaching should be done in severalshort sessions. As a nurse it is of great importance to have knowledge about the linkbetween diabetes and cognitive dysfunction. Changes in behaviour of these individualsshould be detected and lead to careful nursing status. Nurses should be aware of boththe person and her/his spouse in the planning of care and assistance to self-care.Unfortunately, no qualitative articles were found in this literature study who describedself-care strategies from a person-centred perspective. It would be of great importancethat further empirical studies are performed to illuminate this field.</p><p><strong> </strong></p>

Sambandet mellan diabetes och kognitiv dysfunktion har visats i ett flertal studier detsenaste decenniet. Syftet med denna systematiska litteraturstudie var att belysa faktorersom påverkar omvårdnaden av personer med diabetes och kognitiv dysfunktion. Niovetenskapliga artiklar valdes ut i databaserna Cinahl, Clinical Evidence, Cochrane,ELIN@Kristianstad och psycINFO. Dessa kvalitetsbedömdes enligt granskningsmall.Artiklarna analyserades deduktivt enligt Kims domäner personen, omgivningen,yrkesfunktionen och mötet. Fyra huvudfynd identifierades: betydelsen för personen attanpassa sin livssituation och självidentitet, betydelsen av närståendes engagemang ochstöttning, den positiva effekten på den kognitiva förmågan vid regelbunden fysiskaktivitet samt att undervisning bör ske vid korta upprepade sessioner. Somsjuksköterska är det av stor vikt att ha kunskap om sambandet diabetes och kognitivdysfunktion. Beteendeförändringar hos dessa personer bör vara ett observandum somleder till noggrant omvårdnadsstatus. Sjuksköterskan bör i planeringen av omvårdnadoch hjälp till egenvård uppmärksamma både personen och dess närstående. Detframkom i denna litteraturstudie inga kvalitativa artiklar som beskrevegenvårdsstrategier ur ett personcentrerat perspektiv. Önskvärt vore att empiriskastudier kommer till stånd för att belysa detta område. / The relationship between diabetes and cognitive dysfunction has been shown in severalstudies in last decade. The aim of this systematic literature review was to illuminatefactors that affect the nursing care of people with diabetes and cognitive dysfunction.Nine scientific articles were selected form the databases Cinahl, Clinical Evidence,Cochrane, ELIN@Kristianstad and psycINFO. These were assessed according to aquality review template. The articles were analysed deductively according to SuzieKim´s domains of nursing client, client-nurse, environment and practice. Four keyfindingswhere identified: importance for the person to adjust their lives and selfidentity,importance of engagement and support from spouse, the positive effect ofregular physical activity on cognitive ability and that teaching should be done in severalshort sessions. As a nurse it is of great importance to have knowledge about the linkbetween diabetes and cognitive dysfunction. Changes in behaviour of these individualsshould be detected and lead to careful nursing status. Nurses should be aware of boththe person and her/his spouse in the planning of care and assistance to self-care.Unfortunately, no qualitative articles were found in this literature study who describedself-care strategies from a person-centred perspective. It would be of great importancethat further empirical studies are performed to illuminate this field.