Other Titles

Older Adults' Perception of Cognition & CGM Use: Technology Acceptance and Cognitive Health in Type 2 Diabetes Management [Title Slide]

Abstract

CGM is used to examine glucose data against reports of diabetes self-management (DMSM) behaviors, allowing characterization of biobehavioral processes.1 The inclusion of DMSM behaviors is crucial to a full understanding of the relationships between glucose variability and cognitive function.2,3 Unfortunately, only a few trials have evaluated the effectiveness of CGM in older adults with T2DM.4,5 Because older adults with T2DM are a heterogeneous group with variable functional and cognitive abilities, clinicians must consider whether each patient can use CGM and which CGM device that best fits patients' needs. The purpose of this project was to investigate how older adults with T2DM felt cognitive function affected their CGM use.

This qualitative descriptive study consisted of interviews and thematic analysis. A purposive sample of adults with T2DM who used CGMs, was recruited from a community clinic. Inclusion criteria were: (1) having T2DM for at least 2 years; (2) currently using a CGM, and (3) 65 to 80 years of age. Exclusion criteria were having type 1 diabetes or a significant co-morbidity that affected cognition (e.g., Alzheimer’s). The interview consisted of 6 open-ended questions informed by the Technology Acceptance Model 6 and the Theoretical Framework of Acceptability7. The consolidated criterion for reporting qualitative research (COREQ) checklist was used to report the data.8

Interviews were recorded and lasted 45 minutes to 1.5 hours. Participants (n=19) were mostly female (55.0 %) with an average age of 69.79 years (SD=5.41). Most controlled their glucose with oral medication (85.7 %). Four overarching themes were found: (1) utilization of CGM; (2) practicality and usability; (3) barriers and challenges and (4) improved control. Nine subcategories were identified: (1) visual information; (2) predictive functionality; (3) convenience compared fingersticks; (4) senior-friendly design; (5) knowledge becomes a burden; (6) financial burden; (7) operational inconvenience; (8) variability correlates with cognitive function; and (9) lack of healthcare provider knowledge.

The results of the study show that CGM is a viable option to help manage glucose and that glucose levels and perceived cognitive function were intertwined. To effectively implement technological solutions like CGM, it is crucial to identify challenges faced by users and provide necessary support –especially for adults with T2DM who are at greater risk for cognitive dysfunction.

Notes


Research reported in this presentation was supported by National Institutes of Nursing Research of the National Institutes of Health under award number R21NR019266

References:

1. Oser TK, Hall TL, Dickinson LM, Callen E, Carroll JK, Nease DE Jr, Michaels L, Oser SM. Continuous Glucose Monitoring in Primary Care: Understanding and Supporting Clinicians' Use to Enhance Diabetes Care. Ann Fam Med. 2022 Nov-Dec;20(6):541-547. doi: 10.1370/afm.2876.

2. Cuevas H, Stuifbergen AK, Hilsabeck R, Kim J, Wood S. Perceived Cognitive Function and Glycemic Variability: Baseline Results From a Cognitive Rehabilitation Intervention. Sci Diabetes Self Manag Care. 2024 Aug;50(4):310-319. doi: 10.1177/26350106241262720

3. Dong S, Wang L, Zhao C, Zhang R, Gao Z, Jiang L, Guo Y, Zhou H, Xu S. Relationship between key continuous glucose monitoring-derived metrics and specific cognitive domains in patients with type 2 diabetes mellitus. BMC neurology. 2023 May 20;23(1):200.

4. Mayberry LS, Guy C, Hendrickson CD, McCoy AB, Elasy T. Rates and Correlates of Uptake of Continuous Glucose Monitors Among Adults with Type 2 Diabetes in Primary Care and Endocrinology Settings. J Gen Intern Med. 2023 Aug;38(11):2546-2552. doi: 10.1007/s11606-023-08222-3.

5. Munshi MN. Continuous glucose monitoring use in older adults for optimal diabetes management. Diabetes technology & therapeutics. 2023 Jun 1;25(S3):S-56.

6. Davis FD, Bagozzi RP, Warshaw PR. Technology acceptance model. J Manag Sci. 1989;35(8):982-1003

7. Sekhon M, Cartwright M, Francis JJ. Development of a theory-informed questionnaire to assess the acceptability of healthcare interventions. BMC health services research. 2022 Mar 1;22(1):279.

8. Tong A, Sainsbury P, Craig J. Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. International journal for quality in health care. 2007 Dec 1;19(6):349-57.

Description

Focus: Academic

Status: Complete Work/Project

This qualitative study explored how older adults with type 2 diabetes perceive their cognitive function in relation to continuous glucose monitor use (CGM). Participants (n = 19; aged 65–84) were interviewed. Four major themes emerged: CGM utilization, usability, barriers, and improved control. Subthemes included device design, cognitive demands, and financial burden. Findings suggest CGMs are useful for older adults but must align with cognitive and functional abilities for effective use.

Author Details

Heather E. Cuevas, PhD and Jeeyeon Kim, PhD

Sigma Membership

Eta Gamma

Type

Presentation

Format Type

Text-based Document

Study Design/Type

Descriptive/Correlational

Research Approach

Qualitative Research

Keywords:

Primary Care, Continuous Glucose Monitoring, Diabetes Self-Management, Type 2 Diabetes, T2DM, Older Adults, Aged

Conference Name

37th International Nursing Research Congress

Conference Host

Sigma Theta Tau International

Conference Location

Toronto, Ontario, Canada

Conference Year

2026

Rights Holder

All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record. All permission requests should be directed accordingly and not to the Sigma Repository. All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.

Review Type

Abstract Review Only: Reviewed by Event Host

Acquisition

Proxy-submission

Date of Issue

2026-07-20

Funder

National Institute of Health

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Perceived Cognitive Function and Continuous Glucose Monitor Use in Older Adults: A Qualitative Study

Toronto, Ontario, Canada

CGM is used to examine glucose data against reports of diabetes self-management (DMSM) behaviors, allowing characterization of biobehavioral processes.1 The inclusion of DMSM behaviors is crucial to a full understanding of the relationships between glucose variability and cognitive function.2,3 Unfortunately, only a few trials have evaluated the effectiveness of CGM in older adults with T2DM.4,5 Because older adults with T2DM are a heterogeneous group with variable functional and cognitive abilities, clinicians must consider whether each patient can use CGM and which CGM device that best fits patients' needs. The purpose of this project was to investigate how older adults with T2DM felt cognitive function affected their CGM use.

This qualitative descriptive study consisted of interviews and thematic analysis. A purposive sample of adults with T2DM who used CGMs, was recruited from a community clinic. Inclusion criteria were: (1) having T2DM for at least 2 years; (2) currently using a CGM, and (3) 65 to 80 years of age. Exclusion criteria were having type 1 diabetes or a significant co-morbidity that affected cognition (e.g., Alzheimer’s). The interview consisted of 6 open-ended questions informed by the Technology Acceptance Model 6 and the Theoretical Framework of Acceptability7. The consolidated criterion for reporting qualitative research (COREQ) checklist was used to report the data.8

Interviews were recorded and lasted 45 minutes to 1.5 hours. Participants (n=19) were mostly female (55.0 %) with an average age of 69.79 years (SD=5.41). Most controlled their glucose with oral medication (85.7 %). Four overarching themes were found: (1) utilization of CGM; (2) practicality and usability; (3) barriers and challenges and (4) improved control. Nine subcategories were identified: (1) visual information; (2) predictive functionality; (3) convenience compared fingersticks; (4) senior-friendly design; (5) knowledge becomes a burden; (6) financial burden; (7) operational inconvenience; (8) variability correlates with cognitive function; and (9) lack of healthcare provider knowledge.

The results of the study show that CGM is a viable option to help manage glucose and that glucose levels and perceived cognitive function were intertwined. To effectively implement technological solutions like CGM, it is crucial to identify challenges faced by users and provide necessary support –especially for adults with T2DM who are at greater risk for cognitive dysfunction.