title: Diabetes and dementia in older people: a Best Clinical Practice Statement by a multidisciplinary National Expert Working Group.
abstract: Both dementia and diabetes mellitus are long-term disabling conditions and each may be a co-morbidity of the other. Type 2 diabetes is associated with a 1.5- to 2-fold higher risk of dementia. Diabetes also may occur for the first time in many individuals with mental ill health, including cognitive impairment and dementia, and this may complicate management and lead to difficulties in self-care. Case finding is often poor for cognitive impairment in medical settings and for diabetes in mental health settings and this needs to be addressed in the development of care pathways for both conditions. Many other deficiencies in quality care (both for dementia and diabetes) currently exist, but we hope that this Best Clinical Practice Statement will provide a platform for further work in this area. We have outlined the key steps in an integrated care pathway for both elements of this clinical relationship, produced guidance on identifying each condition, dealt with the potentially hazardous issue of hypoglycaemia, and have outlined important competencies required of healthcare workers in both medical/diabetes and mental health settings to enhance clinical care.
authors.affiliation: Institute of Diabetyes for Older People (IDOP), University of Bedfordshire, Luton.
authors.forename: A J
authors.initials: AJ
authors.lastname: Sinclair
authors.forename: R
authors.initials: R
authors.lastname: Hillson
authors.forename: A J
authors.initials: AJ
authors.lastname: Bayer
mesh_terms: D000368:Aged; D000544:Alzheimer Disease / Q000175:diagnosis / Q000628:therapy; D002491:Central Nervous System Agents / Q000627:therapeutic use; D002983:Clinical Competence; D015897:Comorbidity; D019091:Critical Pathways; D003704:Dementia / Q000175:diagnosis* / Q000628:therapy*; D015140:Dementia, Vascular / Q000175:diagnosis / Q000628:therapy; D048909:Diabetes Complications / Q000175:diagnosis / Q000517:prevention & control; D003920:Diabetes Mellitus / Q000097:blood / Q000175:diagnosis* / Q000628:therapy*; D006282:Health Personnel / Q000193:education / Q000592:standards; D006801:Humans; D006943:Hyperglycemia / Q000209:etiology / Q000517:prevention & control; D007003:Hypoglycemia / Q000139:chemically induced / Q000517:prevention & control; D007004:Hypoglycemic Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D033183:Interdisciplinary Communication; D009313:National Health Programs; D009460:Neurologic Examination; D009483:Neuropsychological Tests; D010353:Patient Education as Topic; D011320:Primary Health Care / Q000379:methods / Q000592:standards / Q000639:trends; D011379:Prognosis; D012648:Self Care; D006113:United Kingdom
chemical_list: D002491:Central Nervous System Agents; D007004:Hypoglycemic Agents