General Practitioners’ Judgment of their Elderly Patients’ Cognitive Status

• Published in: Journal of general internal medicine : JGIM 2009-12, Vol.24 (12), p.1314-1317
• Main Authors: Pentzek, Michael, Fuchs, Angela, Wiese, Birgitt, Cvetanovska-Pllashniku, Gabriela, Haller, Franziska, Maier, Wolfgang, Riedel-Heller, Steffi G., Angermeyer, Matthias C., Bickel, Horst, Mösch, Edelgard, Weyerer, Siegfried, Werle, Jochen, van den Bussche, Hendrik, Eisele, Marion, Kaduszkiewicz, Hanna
• Format: Article
• Language: English
• Subjects: Adult; Age Factors; Aged; Aged, 80 and over; Attitude of Health Personnel; Biological and medical sciences; Brief Report; Cognition & reasoning; Cognition Disorders - diagnosis; Cognition Disorders - psychology; Cohort Studies; Cross-Sectional Studies; Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases; Dementia; Female; General aspects; Geriatrics; Humans; Internal Medicine; Judgment; Male; Medical sciences; Medicine; Medicine & Public Health; Middle Aged; Neurology; Physician-Patient Relations; Physicians; Physicians, Family - standards; Primary care
• ISSN: 0884-8734; 1525-1497
• DOI: 10.1007/s11606-009-1118-2

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.