Journal of General Internal Medicine, 2009, Vol.24(12), pp.1314-1317
Byline: Michael Pentzek (1), Angela Fuchs (1), Birgitt Wiese (2), Gabriela Cvetanovska-Pllashniku (3), Franziska Haller (3), Wolfgang Maier (3), Steffi G. Riedel-Heller (4), Matthias C. Angermeyer (5), Horst Bickel (6), Edelgard Mosch (6), Siegfried Weyerer (7), Jochen Werle (7), Hendrik Bussche (8), Marion Eisele (8), Hanna Kaduszkiewicz (8) Keywords: general practice; cognition; dementia; clinical judgment 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. Author Affiliation: (1) Department of General Practice, University Medical Center Dusseldorf, Moorenstrasse 5, 40225, Dusseldorf, Germany (2) Center of Biometrics and Medical Informatics, Hannover Medical School, 30625, Hannover, Germany (3) Department of Psychiatry, University of Bonn, 53105, Bonn, Germany (4) Public Health Research Unit, Department of Psychiatry, University of Leipzig, 04317, Leipzig, Germany (5) Center for Public Mental Health, 3482, Gosing am Wagram, Austria (6) Clinic and Polyclinic for Psychiatry and Psychotherapy, Munich Technical University, 81675, Munich, Germany (7) Central Institute of Mental Health, 68159, Mannheim, Germany (8) Department for Primary Medical Care, Center of Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany Article History: Registration Date: 02/09/2009 Received Date: 12/01/2009 Accepted Date: 02/09/2009 Online Date: 21/10/2009 Article note: Further members of the AgeCoDe Study Group: Heinz-Harald Abholz, Cadja Bachmann, Michaela Buchwald, Mirjam Colditz, Moritz Daerr, Sandra Eifflander-Gorfer, Sven Heinrich, Frank Jessen, Teresa Kaufeler, Hans-Helmut Konig, Tobias Luck, Melanie Luppa, Manfred Mayer, Julia Olbrich, Heinz-Peter Romberg, Anja Rudolph, Melanie Sauder, Britta Schuermann, Michael Wagner, Anja Wollny, and Thomas Zimmermann.
general practice ; cognition ; dementia ; clinical judgment
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