General Practitioners' Judgment of Their Elderly Patients' Cognitive Status

Overview

Journal J Gen Intern Med

Publisher Springer

Specialty General Medicine

Date 2009 Oct 22

PMID 19844763

Citations 7

Authors

Michael Pentzek

Angela Fuchs

Birgitt Wiese

Gabriela Cvetanovska-Pllashniku

Franziska Haller

Wolfgang Maier

Steffi G Riedel-Heller

Matthias C Angermeyer

Horst Bickel

Edelgard Mosch

Siegfried Weyerer

Jochen Werle

Hendrik van den Bussche

Marion Eisele

Hanna Kaduszkiewicz

Affiliations

Soon will be listed here.

Abstract

Background: General practitioners (GP) play an important role in detecting cognitive impairment among their patients.

Objectives: To explore factors associated with GPs' judgment of their elderly patients' cognitive status.

Design: Cross-sectional data from an observational cohort study (AgeCoDe study); General practice surgeries in six German metropolitan study centers; home visits by interviewers.

Participants: 138 GPs, 3,181 patients (80.13 +/- 3.61 years, 65.23% female).

Measurements: General practitioner questionnaire for each patient: familiarity with the patient, patient morbidity, judgment of cognitive status. Home visits by trained interviewers: sociodemographic and clinical data, psychometric test performance. Multivariate regression analysis was used to identify independent associations with the GPs' judgment of "cognitively impaired" vs. "cognitively unimpaired."

Results: Less familiar patients (adjusted odds ratio [aOR] 2.42, 95% CI 1.35-4.32, for poor vs. very high familiarity), less mobile patients (aOR 1.29, 95% CI 1.13-1.46), patients with impaired hearing (aOR 5.46, 95% CI 2.35-12.67 for serious vs. no problems), and patients with greater comorbidity (aOR 1.15, 95% CI 1.08-1.22) were more likely to be rated as "cognitively impaired" by their GPs.

Conclusions: The associations between GPs' assessments of cognitive impairment and their familiarity with their patients and patients' mobility, hearing, and morbidity provide important insights into how GPs make their judgments.

Citing Articles

A Diagnostic Test Accuracy Study Investigating General Practitioner Clinical Impression and Brief Cognitive Assessments for Dementia in Primary Care, Compared to Specialized Assessment.

Creavin S, Fish M, Lawton M, Cullum S, Bayer A, Purdy S J Alzheimers Dis. 2023; 95(3):1189-1200.

PMID: 37694368 PMC: 7615275. DOI: 10.3233/JAD-230320.

Clinical judgement by primary care physicians for the diagnosis of all-cause dementia or cognitive impairment in symptomatic people.

Creavin S, Noel-Storr A, Langdon R, Richard E, Creavin A, Cullum S Cochrane Database Syst Rev. 2022; 6:CD012558.

PMID: 35709018 PMC: 9202995. DOI: 10.1002/14651858.CD012558.pub2.

Clinical judgment of GPs for the diagnosis of dementia: a diagnostic test accuracy study.

Creavin S, Haworth J, Fish M, Cullum S, Bayer A, Purdy S BJGP Open. 2021; 5(5).

PMID: 34315715 PMC: 8596317. DOI: 10.3399/BJGPO.2021.0058.

Psychometric Evaluation and Workflow Integration Study of a Tablet-Based Tool to Detect Mild Cognitive Impairment in Older Adults: Protocol for a Mixed Methods Study.

McMurray J, Levy A, Holyoke P JMIR Res Protoc. 2021; 10(5):e25520.

PMID: 34018966 PMC: 8178737. DOI: 10.2196/25520.

[People with dementia in primary care : Prevalence, incidence, risk factors and interventions].

Thyrian J Z Gerontol Geriatr. 2017; 50(Suppl 2):32-38.

PMID: 28386806 DOI: 10.1007/s00391-017-1223-5.

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