Cognitive impairment no dementia and associations with health literacy, self-management skills, and functional health status.

The analysis was cross-sectional, so it cannot show that cognitive impairment caused the observed self-management or health literacy problems. The sample was English-speaking, mostly female, and recruited from health-seeking primary care settings with multiple chronic conditions, so it may not represent other older adults. Physical function, depression, and anxiety were measured by self-report, which may be less accurate in people with cognitive impairment. The cognitive impairment cutoff was lower than some clinical definitions, so the group may include people with very subtle impairment. Cognitive impairment was not verified by subjective reports of cognitive change.

The article is listed as supported by NIH extramural funding. Author disclosures include: SDP receives research support from Omron Healthcare and previously received grant support from Pfizer, Inc.; MSW receives research funding from Amgen and Merck, Sharpe & Dohme and has served as a paid consultant to Luto U.K., Pfizer, and AB Imbev Foundation.

Do not read the CIND associations with health literacy and self-management as proof that cognition causes self-care problems. The study was cross-sectional and cannot establish direction. Do not assume CIND is linked to physical function or mood, because those links did not remain associated after considering demographics and chronic conditions.