# HOME DM-BAT: Home-based Diabetes-Modified Behavioral Activation Treatment for Low Income Seniors with T2DM Diversity Supplement

> **NIH NIH R01** · MEDICAL COLLEGE OF WISCONSIN · 2020 · $138,578

## Abstract

Nearly one third of adults aged 60 and older have diabetes, and it is known that elderly patients with diabetes
have increased risk of mortality and comorbid conditions such as cardiovascular diseases, chronic pain, and
cognitive impairment (CI). African Americans and Hispanics/Latinos are about two times as likely to have
diabetes than non-Hispanic Whites. The proportion of minority elders with poor glycemic control has been
found to be significantly higher compared to non-Hispanic White elders. While there are about 16 million
people with some degree of cognitive impairment in the US, minorities are disproportionately impacted by
cognitive impairment with 6.9% of Non-Hispanic White, 9.4% of NHB, and 11.5% of Hispanics aged 65 and
older, having been diagnosed with Alzheimer’s or dementia. Cognitive impairment is associated with increased
mortality; additionally, those with mild cognitive impairment progress to developing Alzheimer’s dementia and
have difficulty exercising good judgement, remaining active or social, understanding speech or written
communications, remembering names and appointments, and completing daily tasks and diabetes
management self-care activities. Functional limitations in activities of daily living (i.e. walking, bathing,
dressing) (ADL’s) and instrumental activities of daily living (i.e. housework, preparing meals, shopping)
(IADL’s) may impact clinical outcomes in elderly minority patients with diabetes by reducing their ability to
maintain previously established self-care routines due to cognitive impairment. Research has shown that
almost 40% of older people with diabetes have functional limitations. These limitations and disabilities result in
a poorer quality of life for older adults with functional limitations. Additionally, it is worthwhile to examine the
role of cultural factors such as perceived discrimination, trust, locus of control, and spirituality on clinical
(HbA1C, LDL, blood pressure) and behavioral (self-care – diet, exercise, and medication adherence)
outcomes, and quality of life in this group. There are three important unanswered questions that this study will
attempt to answer: 1) What degree of cognitive impairment and functional limitations lead to poor self-care
behaviors, poor clinical outcomes and poor quality of life in elderly minorities with type 2 diabetes? 2) What are
the pathways and the mechanisms by which cognitive impairment and functional limitations (ADLs, IADLs) lead
to poor self-care behaviors, poor clinical outcomes and poor quality of life in elderly minorities with type 2
diabetes? 3) Do cultural constructs such as perceived discrimination, trust, locus of control, and spirituality
individually and cumulatively lead to poor self-care behaviors, poor clinical outcomes and poor quality of life in
elderly minorities with type 2 diabetes and if so via what process? This study will provide new knowledge and
set the groundwork for future intervention development as well as position the...

## Key facts

- **NIH application ID:** 10033692
- **Project number:** 3R01DK118038-02S1
- **Recipient organization:** MEDICAL COLLEGE OF WISCONSIN
- **Principal Investigator:** Leonard E. Egede
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $138,578
- **Award type:** 3
- **Project period:** 2019-04-01 → 2024-01-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10033692

## Citation

> US National Institutes of Health, RePORTER application 10033692, HOME DM-BAT: Home-based Diabetes-Modified Behavioral Activation Treatment for Low Income Seniors with T2DM Diversity Supplement (3R01DK118038-02S1). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10033692. Licensed CC0.

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