Improving Care for Nursing Home residents with Diabetes and Cognitive Impairment

Public Health Significance: Nursing home (NH) residents with diabetes and Alzheimer?s disease and related dementias are a large, growing population at high risk for adverse outcomes. Unfortunately, little is known about current clinical care practices or the outcomes that result from those care practices in NH residents with diabetes and Alzheimer?s disease and related dementias. The proposed studies will examine those clinical practices and outcomes in NH residents with diabetes across the spectrum of severity of Alzheimer?s disease and related dementias. Research Aims: The proposed projects will compare the rates of fingerstick glucose measurement across the spectrum of severity of Alzheimer?s disease and related dementias (Aim 1), compare the rates of mild hypoglycemia (defined as American Diabetes Association or ADA level 1: glucose 70-54 mg/dL) and moderate hypoglycemia (ADA level 2: glucose